Well Elderly 2, Los Angeles, California, 2004-2008 (ICPSR 33641)

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Date of Collection View help for Date of Collection

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Study Purpose View help for Study Purpose

The primary aim of this study was to determine the effectiveness and cost-effectiveness of a preventive lifestyle-based occupational therapy intervention, administered in a variety of community-based sites, in improving mental and physical well-being and cognitive functioning in ethnically diverse older people.

Study Design View help for Study Design

Older people are at risk for health decline and loss of independence. Lifestyle interventions offer potential for reducing such negative outcomes. The primary aim of this study was to determine the effectiveness and cost-effectiveness of a preventive lifestyle-based occupational therapy intervention, administered in a variety of community-based sites, in improving mental and physical well-being and cognitive functioning in ethnically diverse older people. A randomized controlled trial was conducted comparing an occupational therapy intervention and a no-treatment control condition over a six-month experimental phase. Participants included 460 men and women aged 60 - 95 years recruited from 21 sites in the greater Los Angeles metropolitan area. For the first six months of their participation, elders in Group A received the Well Elderly Intervention. Elders in Group B remained untreated for the first six months and received the intervention during the second six-month phase. Following receipt of the intervention, subjects in both groups remained untreated for respective twelve-month spans. The manualized intervention consisted of small group and individual sessions led by a licensed occupational therapist. Typically, each group had six to eight members, all recruited from the same site and treated by the same intervener. Monthly community outings were scheduled to facilitate direct experience with intervention content such as the use of public transportation. Due to the overt nature of lifestyle programs, neither the therapists nor the treated participants were blind to the intervention. However, the interveners and participants were blind to the study design and hypotheses. An assessment battery (including questionnaires, cognitive tests, and biomarker samples) measured potential mediating variables as well as outcome variables and was administered at study baseline and at subsequent six-month intervals. In addition, at baseline a set of background and control variables were measured. At the end of each assessment session (questionnaires and cognitive tests), subjects were given vials for salivary samples and instructions on how to complete and store the samples at home. Subjects provided four samples on the following day (at rising, 30 minutes after rising, before lunch, before dinner) and stored them in their home freezers. These samples were picked up by a tester and transported on ice to the USC Health Sciences Campus the following day. Samples were shipped to Salimetrics in accordance with Centers for Disease Control guidelines. Upon arrival at Salimetrics, samples were stored at -80 degrees Celsius in a locked freezer until assay. Prior to testing, all samples were exposed to only a single freeze thaw cycle. Samples were assayed for cortisol, dehydroepiandrosterone, and alpha amylase. Assessment of health-related quality of life, life satisfaction and depression was based on self-rated questionnaires and was overseen by trained testers who were blind to the participants' condition assignments. The cognitive tests were conducted individually, in a private area adjacent to the main testing room. Norm-based scores on Version 2 of the 36-Item Short-Form Health Survey (SF-36v2) were used to measure perceived physical health and aspects of mental well-being. The Center for Epidemiologic Studies Depression (CES-D) Scale20 was used to assess depressive symptoms. Life satisfaction was measured by the Life Satisfaction Index-Z (LSI-Z). Three cognitive outcome variables (immediate recall, delayed recall and recognition) were measured by the word list procedure developed by the Consortium to Establish a Registry of Alzheimer's Disease. Selective attention was measured by median reaction time on a widely used computer-based visual search task. Psychomotor speed, was assessed by the Digit Symbol Substitution Task of the Weschler Adult Intelligence Scale.

Sample View help for Sample

Convenience sample randomly assigned to treatment condition. All participants were residents of, users of or visitors to the study recruitment sites; demonstrated no overt signs of psychosis or dementia, and were able to complete the study assessment battery (with assistance, if necessary). All prospective participants completed the informed consent process prior to study entry. Participants were recruited from 21 sites in the greater Los Angeles area, including 9 senior activity centres, 11 senior housing residences, and 1 graduated care retirement community. Recruitment strategies included providing sign-up booths, giving presentations at meetings and social events, and distributing flyers and posters.

Time Method View help for Time Method

Universe View help for Universe

Independent-living older Americans ages 60-95 years.

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Description of Variables View help for Description of Variables

Variable categories included: Health Survey; Stressful Events; Feelings; Connections; Attitudes; Supports; Beliefs; Issues; Activities; and Demographics which asked the respondents age, sex, race, education level, employment, and income.

Response Rates View help for Response Rates

1,109 assessed for eligibility. 838 (76 percent) eligible; 232 randomized to intervention (21 percent of eligible); 228 randomized to control (21 percent of eligible); 460 (55 percent of eligible) enrolled.

Presence of Common Scales View help for Presence of Common Scales

Norm-based scores on Version 2 of the 36-Item Short-Form Health Survey (SF-36v2) were used to measure perceived physical health and aspects of mental well-being. The Center for Epidemiologic Studies Depression (CES-D) Scale20 was used to assess depressive symptoms. Life satisfaction was measured by the Life Satisfaction Index-Z (LSI-Z). Three cognitive outcome variables (immediate recall, delayed recall and recognition) were measured by the word list procedure developed by the Consortium to Establish a Registry of Alzheimer's Disease. Selective attention was measured by median reaction time on a widely used computer-based visual search task. Psychomotor speed, was assessed by the Digit Symbol Substitution Task of the Weschler Adult Intelligence Scale. CES-D: Center for Epidemiologic Studies Depression Scale; SF-36v2: Short Form-36 v2 Health Survey; LSI-Z: Life Satisfaction Index-Z; MCI: Multidimensional Coping Inventory (COPE).

Original Release Date View help for Original Release Date

2012-10-25

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Weight View help for Weight

Standard scoring for established measurement tools.