title: Factors related to dementia patients' length of day-care clinic attendance.
abstract: BACKGROUND
  In our previous study, we reported that patients using a day-care clinic for less than 1 year were older than those who continued day-care activities for more than 1 year. We found that dementia symptoms, as assessed by caregivers using the initial Assessment Scale for Symptoms of Dementia score, influenced the length of day-care clinic attendance (LDC). However, these results were obtained by univariate analysis. In this study, we investigated the factors that influenced LDC using multivariate analysis.
  
  
  METHODS
  We studied data from 457 patients with dementia who attended our day-care clinic for dementia patients from 1 April 2000 to 31 March 2012 and continued intervention until 31 March 2013. We evaluated the factors that influenced LDC using Cox's proportional hazards model for each sex.
  
  
  RESULTS
  Kaplan-Meier analysis showed a gender difference in LDC. The median LDC was 18 months (interquartile range: 3-37 months) for men and 21 months (interquartile range: 5-53 months) for women (P = 0.027). In model 1, the low initial Assessment Scale for Symptoms of Dementia score for each sex and high initial scores for Hasegawa's Dementia Scale-Revised and Nishimura's activity of daily living scale in women were related to the long-term use of day care. Model 2 indicated that a low final score for Nishimura's activity of daily living scale increased LDC for each sex. LDC was not affected by variables related to the caregiving system except for the number of cohabitants in men.
  
  
  CONCLUSIONS
  It was suggested that patients with high cognitive and physical functions attend the day-care clinic for a long time. It was necessary to control the behavioural and psychological symptoms of dementia for those using day care in the long term. However, patients with low physical function at the end of day-care attendance may also attend our day-care service in the long term if they receive favourable assistance.
authors.affiliation: Department of Psychiatry, Tsuruga Onsen Hospital, Tsuruga, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ono
authors.affiliation: Department of Psychiatry, Tsuruga Onsen Hospital, Tsuruga, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tamai
authors.affiliation: Department of Psychiatry, Tsuruga Onsen Hospital, Tsuruga, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takeuchi
authors.affiliation: Department of Internal Medicine, Tsuruga Onsen Hospital, Tsuruga, Japan.
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Tamai
authors.affiliation: Division of Rehabilitation, Tsuruga Onsen Hospital, Tsuruga, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Hasegawa
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001519:Behavior / Q000502:physiology*; D017028:Caregivers / Q000523:psychology; D003071:Cognition / Q000502:physiology*; D003631:Day Care, Medical; D003704:Dementia / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D016016:Proportional Hazards Models; D013997:Time Factors
keywords: behavioural and psychological symptoms; cognitive function; day care; dementia; length of day-care attendance; physical function