34 research outputs found

    Behavioral and psychological symptoms of dementia: The effects of physical activity at adult day service centers

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    Adult day services (ADS) are an increasingly popular option for caregivers of people with dementia, but there is little research on the effects of activities on the behavior and mood of the client. This study examines participation by 94 individuals in different types of adult day-care activities and their association with changes in behavior and psychological symptoms of dementia (BPSD) for the client during a three-month span. Three domains of BPSD were examined: restless behaviors, mood behaviors, and positive behaviors. Using growth curve modeling, results show that the restless and mood behavior domains, on average, were stable over three months, whereas positive behaviors increased. For all three behavior domains there were individual differences in average level of BPSD. Average rate of change for individuals also varied from the mean for restless and mood behaviors. Physical activities, social activities, engaging activities, and watching and listening activities, along with a day-care dosage variable, were used as covariates to explain these individual differences in change. Engaging activities explained some of the individual variance for restless behaviors; as individuals increased one increment in engaging activities, they had fewer restless behavior problems over time. These results suggest that some features of programming may be related to improvements in restless behavior

    Multilevel Models for the Experimental Psychologist: Foundations and Illustrative Examples

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    Although common in the educational and developmental areas, multilevel models are not often utilized in the analysis of data from experimental designs. This article illustrates how multilevel models can be useful with two examples from experimental designs with repeated measurements not involving time. One example demonstrates how to properly examine independent variables for experimental stimuli or individuals that are categorical, continuous, or semicontinuous in the presence of missing data. The second example demonstrates how response times and error rates can be modeled simultaneously within a multivariate model in order to examine speed–accuracy trade-offs at the experimental-condition and individual levels, as well as to examine differences in the magnitude of effects across outcomes. SPSS and SAS syntax for the examples are available electronically

    Exploring the benefits of Respite Services to Family Caregivers: Methodological issues and current Findings

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    Objectives: There is growing emphasis on empirical validation of the efficacy of community-based services for older people and their families, but research on services such as respite care faces methodological challenges that have limited the growth of outcome studies. We identify problems associated with the usual research approaches for studying respite care, with the goal of stimulating use of novel and more appropriate research designs that can lead to improved studies of community-based services. Method: Using the concept of research validity, we evaluate the methodological approaches in the current literature on respite services, including adult day services, in-home respite and overnight respite. Results: Although randomized control trials (RCTs) are possible in community settings, validity is compromised by practical limitations of randomization and other problems. Quasi-experimental and interrupted time series designs offer comparable validity to RCTs and can be implemented effectively in community settings. Conclusion: An emphasis on RCTs by funders and researchers is not supported by scientific evidence. Alternative designs can lead to development of a valid body of research on community services such as respite

    Modeling cortisol daily rhythms of family caregivers of individuals with dementia: Daily stressors and adult day services use

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    Objectives: The study examined the typical diurnal cortisol trajectory and its differential associations with an intervention, the adult day services (ADS) use, among a sample of family caregivers who experienced high levels of daily stress. Method: On hundred and sixty-five caregivers of individuals with dementia completed an 8-day diary on daily stressors, positive events, sleep quality, and ADS use. The caregivers also provided five saliva samples on each diary day. Daily cortisol trajectories were modeled as a function of time elapsed since awakening, and three spline growth curve models were fit to the cortisol data. Based on the best-fitting linear spline model, the effect of daily ADS use was examined at both daily and person levels. Covariates included daily experiences and other caregiving characteristics. Results: On ADS days, caregivers had a steeper cortisol awakening response (CAR) slope and a steeper morning decline. ADS use remained significant after controlling for covariates at both daily and person levels. Discussion: The findings suggested potential biophysiological benefits of daily ADS use for a sample that was under chronic stress and high levels of daily stress
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