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Extended occupational therapy showed no significant improvement in behavioral symptoms for dementia patientsExtended occupational therapy shows no added benefit for dementia

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Key Takeaway
Consider maintaining current occupational therapy coverage policies for dementia patients.

This randomized controlled trial investigated the impact of extended occupational therapy on patients with mild-to-moderate dementia. The study population consisted of community-dwelling adults in France. A total of 238 participants were enrolled in the trial. The setting for the intervention involved occupational therapy services. The comparator group received standard occupational therapy consisting of 12 to 15 home-based sessions over a 3 to 4-month period. The intervention group received occupational therapy maintained for an additional 4 months beyond the standard duration.

The primary outcome measured behavioral symptoms using the Neuropsychiatric Inventory at 8 months. The absolute number of participants assessed for the primary outcome was 211. The main results indicated no significant improvement compared to controls. The adjusted mean difference was -3.8. The 95% confidence interval ranged from -10.3 to 2.7. The p-value indicated no statistical significance for the primary outcome.

Key secondary outcomes included functional performance, depressive symptoms, quality of life, institutionalization, caregivers' burden, and sense of competence. The study did not report specific numerical results for these secondary outcomes in the provided data. Safety and tolerability findings were not reported. There were no reported adverse events, serious adverse events, or discontinuations. Tolerability data were not reported.

The non-significant improvement in behavioral symptoms calls for further long-term trials. This limitation highlights the need for additional research to confirm findings. The study did not support changing the current policy regarding the coverage of the French model of occupational therapy. Funding or conflicts of interest were not reported. The study phase was not reported. The publication type was not reported.

Clinical implications suggest that extending occupational therapy by 4 months does not yield significant behavioral benefits in this population. Practitioners should consider maintaining current policies regarding coverage. Questions remain unanswered regarding long-term effects and secondary outcomes. The lack of reported safety data limits the ability to assess risk-benefit profiles fully.

This trial provides evidence that extended occupational therapy does not significantly alter behavioral symptoms in community-dwelling adults with mild-to-moderate dementia. The findings support the continuation of standard care protocols in this context. Further research is needed to address the identified limitations and explore other therapeutic durations or intensities.

A study in France looked at whether giving people with mild-to-moderate dementia extra occupational therapy (OT) would help reduce behavioral symptoms like agitation or aggression. The study included 238 adults living at home with dementia. All participants first received standard OT, which was 12 to 15 home-based sessions over 3 to 4 months. Then, half of the group continued OT for an additional 4 months, while the other half stopped. Researchers measured behavioral symptoms using a standard test called the Neuropsychiatric Inventory (NPI) at 8 months.

The results showed that the group that got extra OT did not have significantly fewer behavioral symptoms than the group that stopped. The average difference between the groups was small and not statistically meaningful. This means that extending OT beyond the standard program did not provide extra benefit for managing behavioral symptoms. The study also looked at other outcomes like daily function, mood, quality of life, and caregiver burden, but none showed clear improvement from the extra therapy.

It is important to note that the study was well-designed, but the findings suggest that the current French model of OT, which is already quite intensive, may not need to be extended. The researchers point out that more studies are needed to see if different types or durations of OT could help. For now, the results do not support changing the policy that covers the standard OT program.

For people with dementia and their families, this study reinforces that standard OT is valuable, but adding extra sessions may not lead to better outcomes. Caregivers should focus on proven strategies and discuss with their healthcare team what therapies are most appropriate. The study did not report any safety concerns, so the standard OT appears safe.

Overall, this research helps clarify that more therapy is not always better. It highlights the need for careful evaluation of how long and how much therapy is truly helpful. Future studies might explore different approaches, such as targeting specific symptoms or combining OT with other treatments.

What this means for you:
Extended occupational therapy did not reduce behavioral symptoms in dementia more than standard therapy.

Study Details

Study typeRct
Sample sizen = 211
EvidenceLevel 2
Follow-up4.0 mo
PublishedJun 2026
View Original Abstract ↓
BackgroundThere is increasing interest in non-pharmacological approaches to address the needs of patients with Alzheimer's disease and other dementia. However, previous research highlighted the need to adapt interventions to the healthcare system.ObjectiveTo evaluate the effectiveness for community-dwelling patients with mild-to-moderate dementia in France, of maintaining occupational therapy (OT) over a longer period compared with standard OT.MethodsWe used a pragmatic, single-blinded randomized controlled trial (RCT) design (ClinicalTrials.gov NCT03435705). A total of 238 community-dwelling adults with dementia were recruited from OT services and randomly assigned to receive either standard OT (12-15 home-based sessions over a 3-4-month period) or OT maintained for an additional 4 months. The primary outcome was behavioral symptoms measured with the Neuropsychiatric Inventory (NPI) at 8 months. The secondary outcomes included participants' functional performance, depressive symptoms, quality of life, institutionalization, caregivers' burden and sense of competence. Primary analysis followed intention-to-treat. Linear model was used to compare changes in NPI scores between groups at 8 months, with imputation for missing values.ResultsIn total, 211 participants (88.6%) were assessed for the primary outcome at 8 months. Participants benefiting from OT maintenance showed no significant improvement in behavioral symptoms compared to controls (adjusted mean difference = -3.8, 95% confidence interval: -10.3; 2.7). Maintenance of OT had no effect on secondary outcomes.ConclusionsOur pragmatic RCT did not support changing the current policy regarding the coverage of the French model of OT. Nevertheless, the non-significant improvement in behavioral symptoms calls for further long-term trials.
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