Research Society and Development · Nov 2, 2026
Occupational therapy in older age: Innovative home-based interventions to promote autonomy, social participation, and active aging
By dos Santos WJF, da Silva ÉR, dos Santos N
Population aging requires strategies that preserve the autonomy and social participation of older people in their homes. The objective was to synthesize the evidence published between 2020 and 2026 on home-based occupational therapy interventions aimed at autonomy, social participation, and active aging in older people. A systematic review was conducted according to PRISMA 2020, with a PICOS question, risk of bias assessed using RoB 2, ROBINS-I, and JBI, synthesis without meta-analysis guided by SWiM, and certainty of evidence assessed according to GRADE. A total of 31 searches were conducted on October 17, 2026; of 288 records identified, 12 studies were included, nine of them randomized clinical trials, with 3.214 participants. The interventions were grouped into adaptation of the home environment, activity integrated into the routine, caregiver support, and hybrid follow-up. The home hazard removal program reduced the rate of falls by 38%, whereas environmental assessment alone did not reduce falls in a higher-risk sample. The tailored activity program reduced the need for assistance with activities of daily living among people with dementia and improved caregivers' well-being, and telerehabilitation following hip fracture improved instrumental activities. Eight trials had some concerns and one had a high risk of bias, and the certainty of evidence was low or very low. Multicomponent home-based interventions centered on meaningful goals are promising, but trials with social participation outcomes are lacking, providing the rationale for the proposed CASA-Ativa model.