Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: results of the Well Elderly 2 Randomised Controlled Trial

J Epidemiol Community Health. 2012 Sep;66(9):782-90. doi: 10.1136/jech.2009.099754. Epub 2011 Jun 2.


Background: Older people are at risk for health decline and loss of independence. Lifestyle interventions offer potential for reducing such negative outcomes. The 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.

Methods: A randomised controlled trial was conducted comparing an occupational therapy intervention and a no-treatment control condition over a 6-month experimental phase. Participants included 460 men and women aged 60-95 years (mean age 74.9 ± 7.7 years; 53% <$12000 annual income) recruited from 21 sites in the greater Los Angeles metropolitan area.

Results: Intervention participants, relative to untreated controls, showed more favourable change scores on indices of bodily pain, vitality, social functioning, mental health, composite mental functioning, life satisfaction and depressive symptomatology (ps<0.05). The intervention group had a significantly greater increment in quality-adjusted life years (p<0.02), which was achieved cost-effectively (US $41218/UK £24868 per unit). No intervention effect was found for cognitive functioning outcome measures.

Conclusions: A lifestyle-oriented occupational therapy intervention has beneficial effects for ethnically diverse older people recruited from a wide array of community settings. Because the intervention is cost-effective and is applicable on a wide-scale basis, it has the potential to help reduce health decline and promote well-being in older people. Trial Registration clinicaltrials.gov identifier: NCT0078634.

Trial registration: ClinicalTrials.gov NCT00786344.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition / physiology
  • Comparative Effectiveness Research
  • Cross-Over Studies
  • Female
  • Geriatric Assessment*
  • Health Behavior / ethnology
  • Health Promotion / economics*
  • Health Services for the Aged / economics*
  • Health Status Indicators*
  • Humans
  • Life Style* / ethnology
  • Los Angeles
  • Male
  • Mental Recall
  • Middle Aged
  • Occupational Therapy / economics*
  • Occupational Therapy / psychology
  • Outcome Assessment, Health Care
  • Quality of Life*
  • Quality-Adjusted Life Years
  • Residence Characteristics / statistics & numerical data

Associated data

  • ClinicalTrials.gov/NCT00786344