A randomized controlled trial study of a life review art intervention for older adults living alone

BACKGROUND: Older adults living alone face high risks of depression and functional decline; culturally adapted, non-pharmacological options are needed. OBJECTIVE: To test whether a 12-week Life Review Art Therapy (LRAT) program improves psychological well-being and adaptive functioning in older adults living alone (OALA). METHODS: A randomized controlled trial was conducted with 22 participants (experimental n = 11; control n = 11). Primary outcomes were depressive symptoms, measured by the Geriatric Depression Scale-15 (GDS-15) and the Beck Depression Inventory-II (BDI-II), and adaptive behavior, measured by the Adaptive Behavior Assessment System-II (ABAS-II). RESULTS: Compared with the control group, the experimental group demonstrated significant reductions in depressive symptoms (GDS-15 post-test mean difference = -9.45; BDI-II post-test mean difference = -15.82) and the General Adaptive Composite (GAC) of adaptive behavior significantly increased (post-test mean difference = 10.64). Significant improvements were observed in the Conceptual and Social domains, while no significant changes were found in the Practical domain. At the skill level, the experimental group demonstrated significant gains in Communication, Self-Direction, Social, and Community Use (p < 0.05), whereas the control group exhibited declines across multiple skills. CONCLUSION: Life Review Art Therapy effectively enhanced both emotional well-being and daily functioning in OALA, supporting its potential as a community-based, non-pharmacological intervention. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT06763757, Unique Protocol ID: 202410001RINA.