Systematic review of occupation- and activity-based health management and maintenance interventions for community-dwelling older adults.

We describe the results of a systematic review of the literature on occupation- and activity-based health management and maintenance interventions for productive aging. We found moderate to strong evidence that client-centered occupational therapy improved physical functioning and occupational performance related to health management in community-dwelling older adults, as well as in adults with osteoarthritis and macular degeneration. We found moderate evidence that health education programs reduce pain and increase physical activity and that individualized health action plans improve activities of daily living function and participation in physical activities. The evidence that self-management programs result in a decrease in pain and disability and that incorporating cognitive-behavioral principles into physical activity improves long-term participation in exercise was also moderate. Although the evidence for skill-specific training in isolation is limited, effectiveness increases when skill-specific training is combined with health management programs. The implications for practice, education, and research are discussed.