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Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial
Graff MJ, Vernooij-Dassen MJ, Thijssen M, Dekker J, Hoefnagels WH, Rikkert MG.. BMJ (Clinical research ed.), 2006-11-17
Topic: Risk, prevention and care in population studies
Objective To determine the effectiveness of community based occupational therapy on daily functioning of patients with dementia and the sense of competence of their care givers. Design Single blind randomised controlled trial. Assessors were blinded for treatment allocation. Setting Memory clinic and day clinic of a geriatrics department and participants' homes. Participants 135 patients aged > or =65 with mild to moderate dementia living in the community and their primary care givers. Interventions 10 sessions of occupational therapy over five weeks, including cognitive and behavioural interventions, to train patients in the use of aids to compensate for cognitive decline and care givers in coping behaviours and supervision. Main outcome measures Patients' daily functioning assessed with the assessment of motor and process skills (AMPS) and the performance scale of the interview of deterioration in daily activities in dementia (IDDD). Care giver burden assessed with the sense of competence questionnaire (SCQ). Participants were evaluated at baseline, six weeks, and three months. Results Scores improved significantly relative to baseline in patients and care givers in the intervention group compared with the controls (differences were 1.5 (95% confidence interval 1.3 to 1.7) for the process scale; -11.7 (-13.6 to -9.7) for the performance scale; and (11.0; 9.2 to 12.8) for the competence scale). This improvement was still significant at three months. The number needed to treat to reach a clinically relevant improvement in motor and process skills score was 1.3 (1.2 to 1.4) at six weeks. Effect sizes were 2.5, 2.3, and 1.2, respectively, at six weeks and 2.7, 2.4, and 0.8, respectively, at 12 weeks. Conclusions Occupational therapy improved patients' daily functioning and reduced the burden on the care giver, despite the patients' limited learning ability. Effects were still present at 12 weeks, which justifies implementation of this intervention. Trial registration Clinical Trials NCT00295152 [ClinicalTrials.gov].
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APA 7th
Graff, M. J., Vernooij-Dassen, M. J., Thijssen, M., Dekker, J., Hoefnagels, W. H., & Rikkert, M. G. (2006). Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial. BMJ (Clinical research ed.). https://doi.org/10.1136/bmj.39001.688843.be
Vancouver
Graff MJ, Vernooij-Dassen MJ, Thijssen M, Dekker J, Hoefnagels WH, Rikkert MG. Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial. BMJ (Clinical research ed.). 2006. doi:10.1136/bmj.39001.688843.be. PMID: 17114212.
BibTeX
@article{graff2006-17114212,
author = {Graff, M. J. and Vernooij-Dassen, M. J. and Thijssen, M. and Dekker, J. and Hoefnagels, W. H. and Rikkert, M. G.},
title = {{Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial}},
journal = {BMJ (Clinical research ed.)},
year = {2006},
doi = {10.1136/bmj.39001.688843.be},
pmid = {17114212},
url = {https://doi.org/10.1136/bmj.39001.688843.be}
}
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Key findings
- Results Scores improved significantly relative to baseline in patients and care givers in the intervention group compared with the controls (differences were 1.5 (95% confidence interval 1.3 to 1.7) for the process scale; -11.7 (-13.6 to -9.7) for the performance scale; and (11.0; 9.2 to 12.8) for the competence scale).
- This improvement was still significant at three months.
Why it matters
In this randomized controlled trial, community occupational therapy improved patients' daily functioning and caregivers' sense of competence compared with controls. The improvement was still significant at three months.
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Study details
- Study designrandomized controlled trial
- Participants135
- Evidence strengthHigh
How this study scored 76/100
Published in a leading specialty journal, and it is a randomised controlled trial. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (BMJ (Clinical research ed.)) |
| Journal's citation record | 4 / 4 | BMJ: journal h-index 608 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2006 — older than 20 years, still counted |
| Sample size | 2 / 4 | 135 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 2 / 2 | Randomised and blinded or placebo-controlled (as stated in the record) |
| Times cited | 6 / 7 | Cited 502 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 22.8 citations a year over 22 year(s) since 2006 |
| Impact for its field and year | 6 / 6 | Cited 77.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 11 other studies in this library |
| Still being cited | 2 / 4 | Cited 41 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Marcel G. M. Olde Rikkert: h-index 84 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Radboud University Nijmegen: institution h-index 1,143 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 17114212) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 76 / 100 | — |
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