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

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

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

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

Intrinsic emotional fluctuation in daily negative affect across adulthood

Objectives: The study explored daily negative affect (NA) fluctuation, its associations with age, and its developmental characteristics. Method: The sample (n = 790) was drawn from the Midlife Development in the United States; participants completed two 8-day daily diaries 10 years apart. Multilevel models were estimated within each diary component, where two single daily NA (depression and nervousness) and daily NA diversity were predicted separately by daily stressor exposures, physical health symptoms, age, gender, education, and neuroticism. The variances of within-person residual were output for single NA and NA diversity as intrinsic emotion fluctuation (IEF) within each diary component (i.e., controlled for within- and between-person contextual factors). Then multilevel growth models were fit to explore the developmental characteristics of day-to-day IEF across 10 years. Results: At the daily level, older age was associated with less IEF in depression and nervousness. Over time, IEF in depression decreased. Additionally, IEF in NA diversity increased for older participants longitudinally. Discussion: IEF represents a new conceptualization of midlife individuals’ daily emotional ups and downs, specifically, the intrinsic within-person volatility of emotions. The magnitude of IEF and its longitudinal dynamics may have implications for health and well-being of middle-aged adults