title: Use of home-based formal services by adult day care clients with Alzheimer's disease.
abstract: OBJECTIVE
  To explore the association between adult day care (ADC) attendance and utilization of home-based formal services among people with Alzheimer's Disease (AD).
  
  
  METHODS
  Data for this secondary analysis came from a longitudinal parent study of 457 subjects from 16 ADC programs and an Alzheimer's diagnostic center in metropolitan Chicago. We used the method of Generalized Estimating Equations to model the use of home-based formal services over time.
  
  
  RESULTS
  Adjusting for relevant covariates, more days of ADC use at each follow-up was associated with decreased use of home-based formal services (coefficient = .25, p< .0001). Older, unmarried caregivers who are children of the care recipients had lower use of home-based services.
  
  
  CONCLUSIONS
  Results suggest that ADC services may substitute for specific types of home-based formal services. The projected increase in AD prevalence over the next several decades warrants a clearer understanding of how people with AD use formal services.
authors.affiliation: Rush Institute for Healthy Aging, 1645 W. Jackson, Chicago, IL, USA. Kimberly_Skarupski@rush.edu
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Skarupski
authors.forename: Judith J
authors.initials: JJ
authors.lastname: McCann
authors.forename: Julia L
authors.initials: JL
authors.lastname: Bienias
authors.forename: Fredric D
authors.initials: FD
authors.lastname: Wolinsky
authors.forename: Neelum T
authors.initials: NT
authors.lastname: Aggarwal
authors.forename: Denis A
authors.initials: DA
authors.lastname: Evans
mesh_terms: D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000517:prevention & control; D015984:Causality; D002641:Chicago; D003152:Community Health Nursing / Q000706:statistics & numerical data*; D003631:Day Care, Medical / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment; D019538:Health Care Surveys; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D020380:Needs Assessment; D015401:Nursing Administration Research; D009730:Nursing Assessment; D017063:Outcome Assessment, Health Care; D012111:Residence Characteristics; D012959:Socioeconomic Factors