Changes in Functional and Health-Related Outcomes After a Disability-Delay Program Among Community-Dwelling Older...

Background: Frailty, sarcopenia, and cognitive decline are associated with reduced functional independence and participation among older adults. Occupational therapy uses multidomain and participation-focused approaches to support functional independence and healthy aging; however, evidence regarding functional and health-related changes among community-dwelling older adults participating in structured multidomain programs remains limited. This study aimed to describe pre-post changes in functional and health-related outcomes and to explore associations among concurrent changes in these measures. Methods: This uncontrolled retrospective pre-post program evaluation analyzed routinely collected data from 60 community-dwelling older adults who participated in a 12-week occupational therapist-led multidomain community program at five community sites. The program was delivered once weekly for 2 h and incorporated cognitive, physical, and daily activity-related components. Functional ability, frailty, sarcopenia risk, grip strength, cognitive function, and health-related quality of life were assessed at baseline and program completion. Pre-post differences were examined using paired-samples t-tests, and separate age-adjusted linear regression models were used to examine associations between individual clinical change variables and concurrent changes in functional outcomes. Results: Pre-post differences were observed in activities of daily living, frailty, sarcopenia risk, grip strength, cognitive function, and health-related quality of life. In separate exploratory age-adjusted regression models, changes in frailty (SOF), sarcopenia risk (SARC-F), and cognitive function (SPMSQ) were associated with concurrent changes in selected functional outcomes. These associations were considered exploratory and should not be interpreted as evidence of independent prediction or causality. Conclusions: Pre-post changes in multiple functional and health-related outcomes were observed among community-dwelling older adults participating in the 12-week occupational therapist-led multidomain program. Given the uncontrolled retrospective pre-post design, the observed changes cannot be attributed to the program, and the associations among concurrent changes should not be interpreted as causal. These findings may inform occupational therapy practice and the development of community-based multidomain programs aimed at supporting functional independence and participation in daily life. Further prospective controlled studies are needed to confirm these findings and determine whether such programs produce clinically meaningful changes in functional and health-related outcomes.