[Preventing decline of autonomy through the promotion of mental health: a randomized clinical trial for older adults with disabilities]. / La prévention de la perte d'autonomie par le renforcement de la santé mentale : un essai clinique à répartition aléatoire auprès des personnes âgées avec incapacités.

ABSTRACT

Among older adults with disabilities, maintaining active aging can often be compromised. However, the literature highlights a positive link between mental health and autonomy on one hand, and self-determined motivation on the other. Therefore, self-determined motivation may be improved by promoting mental health and, in the end, older adults autonomy. In this context, the « pôle bien-être autonomie ¼, a mental health promotion program, has been set up to offer activities adapted to the disabilities and needs of the elderly, hence fostering active aging. The purpose of this longitudinal study is to test the hypothesis that promoting the mental health of disabled older adults would preserve their autonomy through the development of self-determined motivation. The theoretical model was tested using structural equation modelling on data of 170 participants. A RCT was conducted between 2019 and 2021 with the same cohort. Results of the structural equation modelling support the importance of promoting mental health in maintaining active aging. Evaluation of the promotion program indicates a decrease in levels of depression, an increase in the frequency of self-determined activities and in the autonomy of beneficiaries after three months of operation. The discussion focuses on the relevance of a processual analysis of the promotion program and on new directions to maintain autonomy for seniors with disabilities.