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The Gerontologist 47:775-788 (2007)
© 2007 The Gerontological Society of America

Impact of Adult Day Services on Behavioral and Psychological Symptoms of Dementia

Elia E. Femia, PhD1,, Steven H. Zarit, PhD1, Mary Ann Parris Stephens, PhD2 and Rick Greene, PhD3

Correspondence: Address correspondence to Elia E. Femia, PhD, S-211 Henderson Building, The Pennsylvania State University, University Park, PA 16802. E-mail: exk12{at} or z67{at}

Purpose: 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. Design and 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. Implications: 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.

Key Words: Adult day care • Behavior problems in dementia • Dementia caregiving

All GSA journals Journals of Gerontology Series A: Biological Sciences and Medical Sciences Journals of Gerontology Series B: Psychological Sciences and Social Sciences
Copyright © 2007 by The Gerontological Society of America.