Promoting Healthy Aging: A evidence based role for OT in wellness and prevention

Occupational therapists can play a critical role in healthy aging by promoting physical activity, sleep hygiene, healthy eating, meaningful occupation, and proactive planning for major life transitions. Drawing on both recent research and OT best-practice guidelines, therapists in community or private practice settings can implement detailed interventions that support wellness among older adults, including those looking to establish innovative preventive programming.

Key Research Evidence Supporting Healthy Aging

There is considerable research around the topic of health aging. In this blog, I highlight some recent studies that point to key areas for OT intervention.

• Replacing sedentary behavior (especially television time) with light-intensity physical activity (LPA), moderate-to-vigorous activity (MVPA), or—even for some clients—sleep, significantly improves odds of healthy aging. LPA at home or work each increases the likelihood of aging well, and shifting even an hour per day makes a measurable difference. (Shi et al., 2024)
• Substituting sedentary time for LPA or MVPA also yields improvements in cardiometabolic health markers, including lipid profiles and glucose regulation, for middle-aged adults, regardless of cardiorespiratory fitness. Light activity interventions are particularly feasible for community-dwelling older adults. (Bannigan et al., 2024; Shi et al., 2024)
• Planning interventions for the retirement transition—especially identifying new meaningful activities and fostering social connection—prevents occupational deprivation and promotes life satisfaction and mental wellbeing. Volunteering and purposeful leisure significantly ease the retirement transition, as supported by client-centered planning frameworks like MOHO. (Knust et al., 2021)
• Including dietary habits in healthy aging expands the occupational therapy role: OTs are well-positioned to address dietary behavior change, meal planning, energy management, and routine-building around nutrition. Research shows that adherence to healthful dietary patterns—especially those rich in plant-based foods and low in ultraprocessed items—substantially improves physical, cognitive, and mental outcomes for older adults. (Shi et al., 2024; Tessier et al., 2025).
• Comprehensive OT interventions (including self-management, home modification, cognitive–behavioral sleep strategies, fitness routines, and social participation supports) produce clinically meaningful improvements in ADL/IADL performance, fall risk, sleep quality, and overall wellness for older community-dwelling adults. (Smallfield & Elliot, 2020)

Detailed Action Steps for Community and Private Practice OTs

1. Assess Sedentary Behaviors and Promote Activity Substitution

• Monitor daily sedentary activities such as television viewing or prolonged sitting, using structured logs or wearables when possible. (Shi et al., 2024)
• Collaborate on tailored plans to incrementally replace sedentary blocks with LPA (e.g., standing while phone calls, gentle walking, home chores) and, as tolerated, MVPA (e.g., brisk walking, water aerobics). (Bannigan et al., 2024)
• Encourage and facilitate participation in low-barrier activity groups (e.g., walking clubs, community gardening).

2. Implement and Educate on Sleep Hygiene Interventions

• Conduct sleep assessments as part of wellness screenings using validated tools (e.g., Pittsburgh Sleep Quality Index).
• Teach behavioral strategies: maintain consistent sleep/wake times, limit bed use to sleep, manage light and sound, reduce screens before bed, and address contributors to cognitive/emotional arousal at night (e.g., journaling, calming routines). (Smallfield & Elliot, 2020)

3. Guide Clients Through Retirement and Identity Transitions

• Facilitate structured planning for retirement: identify concerns about role loss, explore new or adapted routines and volunteer opportunities, and connect clients to local resources for active engagement. (Knust et al., 2021)
• Use occupational storytelling and MOHO-informed interviews to explore and reinforce sources of meaning and motivation.
• Develop partnerships with local employers and community organizations to provide seminars on retirement transition and incorporate OT services in employee wellness or pre-retirement programs.

4. Integrate Home and Environmental Modifications

• Assess for and address barriers to safe mobility, self-care, and social participation (e.g., grab bars, handrails, adaptive devices).
• Provide education for clients and caregivers on fall prevention and energy conservation strategies. (Smallfield & Elliot, 2020)
• Collaborate with other professionals as needed (e.g., physical therapists, contractors) to optimize home environments.

5. Address Social Participation and Mental Wellness

• Include interventions targeting social isolation, such as facilitating peer groups, virtual meetups, or community service involvement.
• Connect clients to community resources that match new or evolving interests (e.g., arts, civic groups, fitness classes). (Smallfield & Elliot, 2020)
• Address barriers to participation caused by transport, mobility, or confidence, offering both practical and psychological supports. (Knightbridge et al., 2022)

6. Promote Healthy Dietary Habits

• Long-term adherence to dietary patterns such as the Alternative Healthy Eating Index (AHEI) or healthful plant-based diets boosts healthy aging odds by over two-fold. (Shi et al., 2024)
• Consuming more fruits, vegetables, whole grains, unsaturated fats, nuts, legumes, and low-fat dairy is associated with greater odds of healthy aging, while high intakes of trans fats, sodium, sugary beverages, and processed meats are linked to poorer outcomes.
• OTs can incorporate dietary routines into activity analysis, goal setting, and intervention, helping clients build practical food habits that support energy, physical function, and wellness. (Smallfield & Elliot, 2020)
• Assisting with planning, shopping, meal prep, and using adaptive tools/energy conservation strategies enables older adults or those with chronic conditions to sustain dietary changes despite fatigue or physical limitations, especially in community settings.

Innovating Preventive and Wellness OT Programming

• Develop and pilot group-based wellness programs addressing shared needs (e.g., “Active Aging Clubs” with physical activity, sleep workshops, social participation goals).
• Pioneer pre-retirement OT consultancy with local employers, unions, or faith organizations to support transitions and promote volunteering as a meaningful retirement occupation.
• Evaluate and document outcomes for quality improvement using standardized metrics for function, satisfaction, healthy eating, sleep, and activity participation.

Occupational therapists, through comprehensive, evidence-based approaches, can uniquely support older adults in achieving healthy aging—ensuring holistic wellness that encompasses movement, nutrition, rest, participation, and self-determination at every stage. Occupational therapists play a vital role in activating these healthy aging pathways—empowering older adults to optimize diet, physical activity, sleep, and participation for lifelong health and fulfillment. This evidence-based approach, grounded in both lifestyle medicine research and occupational therapy frameworks, empowers occupational therapists to lead in healthy aging initiatives across settings—proactively mitigating decline and enhancing the quality of later life.

NOW is our time to act. As a profession, occupational therapists have watched reimbursement rates erode year after year, while opportunities grow increasingly limited within a restrictive medical model. With a rapidly expanding aging population and more clients living with chronic conditions, the needs in our communities have never been greater—nor has our potential to lead innovative solutions.

The window for OT transformation is open. We cannot afford to wait for the healthcare system to redefine our value. This is our chance to move occupational therapy forward—expanding beyond the “sick care” paradigm and meeting the preventive, wellness, and participation needs that only we are uniquely qualified to address. Now is the moment to champion activity-based, nutrition-focused, sleep-optimized, and socially connected interventions that make a measurable impact in people’s lives.

If we step into these roles, advocate fiercely, and build new models of care in community and private settings, we will not only secure the future of our profession—we will profoundly change the trajectory of healthy aging for generations to come. The time for action, leadership, and vision is NOW.

References:

Bannigan, K., Larkan, N. J., Meurgue, E. R. R., & Sze, J. C. H. (2024). Characteristics of Occupational Therapy Interventions to Promote Healthy Aging: Protocol for a Scoping Review. JMIR research protocols, 13, e55198. https://doi.org/10.2196/55198

Knightbridge, L., Bourke-Taylor, H. M., & Hill, K. D. (2022). Healthy ageing through participation in community situated activities: A scoping review of assessment instruments to support occupational therapy practice. Australian occupational therapy journal, 69(4), 493–509. https://doi.org/10.1111/1440-1630.12802

Knust, E., Myers, O., and Reuss, B. (2021). “Evidence for Planning as an Intervention Approach for Adults Transitioning Into Retirement” Critically Appraised Topics. 34. https://commons.und.edu/cat-papers/34

Shi, H., Hu, F. B., Huang, T., Schernhammer, E. S., Willett, W. C., Sun, Q., & Wang, M. (2024). Sedentary Behaviors, Light-Intensity Physical Activity, and Healthy Aging. JAMA network open, 7(6), e2416300. https://doi.org/10.1001/jamanetworkopen.2024.16300

Smallfield, S., & Elliott, S. J. (2020). Occupational Therapy Interventions for Productive Aging Among Community-Dwelling Older Adults. The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 74(1), 7401390010p1–7401390010p5. https://doi.org/10.5014/ajot.2020.741003

Tessier, A. J., Wang, F., Korat, A. A., Eliassen, A. H., Chavarro, J., Grodstein, F., Li, J., Liang, L., Willett, W. C., Sun, Q., Stampfer, M. J., Hu, F. B., & Guasch-Ferré, M. (2025). Optimal dietary patterns for healthy aging. Nature medicine, 31(5), 1644–1652. https://doi.org/10.1038/s41591-025-03570-5