The effect of multisensory environment-based occupational therapy intervention on sensory processing, cognitive, behavioral symptoms and caregiver burden in Alzheimer's patients: A randomized controlled study

The aim of this study was to investigate the effects of a multisensory environment–based occupational therapy intervention on cognitive functions, behavioral and psychological symptoms, sensory processing, and caregiver burden in individuals with moderate-stage Alzheimer's disease. Twenty-four participants were randomized into intervention (n=12) and control (n=12) groups. Both groups received occupational therapy twice weekly for eight weeks, while the intervention group additionally received a multisensory environment–based intervention. Participants were assessed before and after the intervention using the Loewenstein Occupational Therapy Cognitive Assessment–Geriatric Version (LOTCA-G), Neuropsychiatric Inventory (NPI), Adult Sensory Processing Scale (ASPS), and Caregiver Burden Inventory (CBI). Compared with the control group, the intervention group showed reductions in hallucinations (p=0.005), disinhibition (p=0.021), irritability (p=0.006), aberrant motor behavior (p=0.005), and overall neuropsychiatric symptoms (p=0.005). Vestibular over-responsivity (p=0.017) and auditory over-responsivity (p=0.002) decreased, while vestibular-proprioceptive motor/postural responses improved (p=0.014). Developmental burden (p=0.006), social burden (p=0.039), emotional burden (p=0.016), and overall caregiver burden (p=0.032) also decreased. No significant between-group difference was found in cognitive functions (p>0.05). Multisensory environment intervention may be used as an adjunct to occupational therapy in managing behavioral and psychological symptoms, supporting sensory processing, and reducing caregiver burden. Future multicenter studies are recommended to examine the long-term sustainability of these effects.