Occupational Therapy Practice Guidelines for Adults Living With Alzheimer's Disease and Related Neurocognitive Disorders

Abstract

Importance: There are currently 55 million adults living with declining functional cognition-altered perception, thoughts, mood, or behavior-as the result of Alzheimer's disease (AD) and related neurocognitive disorders (NCDs). These changes affect functional performance and meaningful engagement in occupations. Given the growth in demand for services, occupational therapy practitioners benefit from consolidated evidence of effective interventions to support adults living with AD and related NCDs and their care partners.

Objective: These Practice Guidelines outline effective occupational therapy interventions for adults living with AD and related NCDs and interventions to support their care partners.

Method: We synthesized the clinical recommendations from a review of recent systematic reviews.

Results: Twelve systematic reviews published between 2018 and 2021 served as the foundation for the practice recommendations.

Conclusion and recommendations: Reminiscence, exercise, nonpharmacological behavioral interventions, cognitive therapy, sensory interventions, and care partner education and training were found to be most effective to support adults living with AD and related NCDs. Plain-Language Summary: These Practice Guidelines provide strong and moderate evidence for occupational therapy practitioners to support adults living with Alzheimer's disease (AD) and related neurocognitive disorders (NCDs) and their care partners. They provide specific guidance for addressing the decline in cognition, behavioral and psychological symptoms of dementia, and pain experience of adults living with AD and related NCDs. The guidelines also describe interventions to support care partners. With support from the evidence, occupational therapy practitioners are better equipped to address the unique needs of adults living with AD and related NCDs and their care partners.

Figure 1.

Interventions to improve cognitive function for individuals living with dementia and mild cognitive impairment. Note. See Table 1 for additional recommendations and details on each study. Occupational therapy practitioners should always consider the evidence, as well as the client’s safety, personal factors, preferences, access to resources, and interests when developing the plan of care and selecting interventions. CBT = cognitive–behavioral therapy.

Figure 2.

Interventions to improve behavioral and psychological symptoms for individuals living with dementia and mild cognitive impairment. Note. See Table 1 for additional recommendations and details on each study. Occupational therapy practitioners should always consider the evidence, as well as the client’s safety, personal factors, preferences, access to resources, and interests when developing the plan of care and selecting interventions. OT = occupational therapy.

Figure 3.

Interventions to improve mental health outcomes for care partners of individuals living with dementia. Note. See Table 1 for additional recommendations and details on each study. Occupational therapy practitioners should always consider the evidence, as well as the client’s safety, personal factors, preferences, access to resources, and interests when developing the plan of care and selecting interventions.