The Effect of a Multimodal Occupational Therapy Program with Cognition-Oriented Approach on Cognitive Function and Activities of Daily Living in Patients with Alzheimer's Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Non-pharmacological intervention, which includes a broad range of approaches, may be an alternative treatment for Alzheimer's disease (AD). Multimodal non-pharmacological intervention alleviates cognitive dysfunction and the impairment of activities of daily living (ADL) in AD patients. However, it is still unclear which combination of non-pharmacological interventions is preferred. We selected a non-pharmacological intervention combined with occupational therapy (OT). We investigated the effect of a multimodal OT program with cognition-oriented approach on cognitive dysfunction and impairments of ADL in patients with AD. Four electronic databases were searched from January 2000 to August 2020. The studies were assessed for heterogeneity, quality assessment, effect size and publication bias. A total of seven randomized controlled trials examining multimodal OT programs with cognition-oriented approach in AD patients were included in the meta-analysis. Compared with the control group, the multimodal OT program with cognition-oriented approach group was statistically beneficial for cognitive dysfunction (95% CI: 0.25-0.91). However, compared with the control group, the multimodal OT program with cognition-oriented approach group tended to be beneficial for basic ADL, and instrumental ADL. These results suggest that the multimodal OT program with cognition-oriented approach might be the optimal multimodal non-pharmacological intervention for improving cognitive dysfunction in AD patients.