As we age, the musculoskeletal, vascular, integument, and nervous systems begin to show signs of degenerative changes that affect hand function-primarily strength, dexterity, and prehension. Bone demineralization, joint "wear and tear," muscle atrophy, decreased sensation, and soft tissue changes combined with associated health conditions decrease a person's functional abilities. As the aging population grows in the United States, with persons older than 65 years of age expected to increase to 19% of the total population by 2030, so will the need for occupational therapy services for adults as they age.
For some older adults, whether retired, partially retired, or still working, deteriorating hand function is a part of the aging process. Shumway-Cook and Woollacott identified several features of decreased reach, grasp, and manipulation in older adults from a motor control perspective.3 These features include reduction in manual dexterity such as manipulating buttons and opening pill bottles, and decreased efficiency in grip-and-lift tasks such as carrying a laundry basket or grasping and lifting a milk carton off a refrigerator shelf. Fortunately, these age-related changes may be addressed through training. If unaddressed, older adults are at risk for decreased occupational performance. Incel and colleagues suggested that a loss of hand function is an important predictor of a reduction in activities of daily living (ADLs) performance and quality of life of older adults