IMPORTANCE: Evidence for the positive effects of occupation-based interventions on occupational performance is increasing; however, little is known about the impacts of occupation-based interventions on older adults living in long-term care. OBJECTIVE: To consolidate the evidence on the effectiveness of occupation-based interventions for improving occupational performance among older adults living in long-term care. DATA SOURCES: Medline, CINAHL, PsycINFO, SCOPUS, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from journal-database inception to February 2023. STUDY SELECTION AND DATA COLLECTION: This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles were peer-reviewed studies published in English that evaluated occupation-based interventions for older adults living in long-term care and used validated tools to measure occupational performance. FINDINGS: Seventeen articles, with 2,974 participants, were identified. The reviewed studies included 6 level 1b randomized controlled trials, 5 level 2b studies of various study designs, and 5 level 3b studies with quasi-experimental designs. Across studies, heterogeneous measures were used to assess occupational performance. All studies implemented client-centered, occupation-based interventions designed and/or delivered by occupational therapists. Interventions were tailored to residents' goals, interests, or abilities to improve occupational performance and participation, and inconsistent effects were reported. CONCLUSIONS AND RELEVANCE: Moderate evidence supports the use of occupation-based interventions tailored to individual residents and incorporation of physical activities for improving the occupational performance of older adults living in long-term care. Currently, evidence for care partner involvement and multilevel occupation-based interventions is limited.
Copyright by the Amerrican Occupational Therapy Association Inc. Reprinted with permission.

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