title: Impact of adult day services on behavioral and psychological symptoms of dementia.
abstract: OBJECTIVE
  This study explored whether adult day service (ADS) use was associated with reductions in behavioral and psychological symptoms of dementia (BPSD) in individuals with dementia.
  
  
  METHODS
  We used a quasi-experimental design to compare a group of 133 persons with dementia (PWDs) who initially enrolled in an ADS program to a control group not using these services (n = 68). Caregivers used a 24-hour log on multiple, consecutive days to report on five domains of BPSD.
  
  
  RESULTS
  We used growth-mixture modeling techniques to model change in the BPSD domains over a 2-month period as well as to handle the preponderance of zeros that were inherent in the data. Results showed a relationship between ADS use and caregivers' report of fewer nighttime sleep-related problems for their PWDs. We found trends for other domains, specifically depressive symptoms and agitated behavior, but no significant group differences emerged for these and the other domains.
  
  
  CONCLUSIONS
  The findings of ADS use on PWDs' duration of nighttime sleep problems provide some evidence of the benefits of ADS; the findings also support its utility as part of the continuum of care for PWDs and their caregivers. For other behavior domains, enhanced or more targeted behavioral strategies coupled with ADS might offer caregivers and their PWDs the best possible combination for ameliorating BPSD.
authors.affiliation: Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, USA. exk12@psu.edu
authors.forename: Elia E
authors.initials: EE
authors.lastname: Femia
authors.forename: Steven H
authors.initials: SH
authors.lastname: Zarit
authors.forename: Mary Ann Parris
authors.initials: MA
authors.lastname: Stephens
authors.forename: Rick
authors.initials: R
authors.lastname: Greene
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001526:Behavioral Symptoms / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D016022:Case-Control Studies; D003631:Day Care, Medical / Q000523:psychology*; D003704:Dementia / Q000451:nursing / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D010414:Pennsylvania; D011595:Psychomotor Agitation / Q000523:psychology; D012044:Regression Analysis; D012892:Sleep Deprivation / Q000523:psychology