EXploring Patterns of Use and Effects of Adult Day Programs to Improve Trajectories of Continuing CarE

NCT06440447 | Not Yet Recruiting

• 1 other identifier: 563198b
• Study Type: observational
• Target: 500,000
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study seeks to understand the impact of Canada's adult day program on attendees and non-attendees, especially those with dementia and other co-morbidities. A retrospective cohort study will be conducted, including older adults in the community who do or do not attend adult day programs in Alberta, British Columbia, and Manitoba, Canada. The objectives are to (1) compare patterns of day program use (including non-use) by Canadian province (Alberta, British Columbia, Manitoba), and time, (2) compare characteristics of older adults by day program use pattern (including non-use), province, and time, and (3) to examine whether those who are exposed to day programs, compared to a propensity-score matched comparison group of non-exposed older adults in the community, enter long-term care homes at later times (primary outcome), are less likely to have depressive symptoms, physical and cognitive change, and have lower use of primary, acute, and emergency care (secondary outcomes).

Conditions

Adult Day Programs; Continuing Care; Old Age; Dementia; Family/friend Caregivers

Keywords

Adult day programs; Older adults; Program evaluation; Cohort studies; Health administrative data

Outcome Measures

Primary Outcomes (1)

• Time to admission to a long-term care homes

  Data will come from provincial continuing care registries, which document the start date of any publicly funded continuing care service a person receives, the end date of this service, and the type of service. The outcome will be the time between a person's first RAI-HC assessment and admission to a long-term care home (i.e., an assisted living home or nursing home).

  From date of home care admission until the date of admission to a long-term care home or loss to follow up (i.e., death, move out of province), whichever came first, assessed up to 12 years (between Jan 31, 2012 and Dec 31, 2024)

Secondary Outcomes (6)

• Symptoms of depression

  Baseline (date of home care admission) and annually until study end (Dec 31, 2024) or loss to follow up, whichever came first

• Presence or absence of physical decline

  Baseline (date of home care admission) and annually until study end (Dec 31, 2024) or loss to follow up, whichever came first

• Presence or absence of cognitive decline

  Baseline (date of home care admission) and annually until study end (Dec 31, 2024) or loss to follow up, whichever came first

• Emergency room registrations

  Baseline (date of home care admission) and annually until study end (Dec 31, 2024) or loss to follow up, whichever came first

• Hospital stays

  Baseline (date of home care admission) and annually until study end (Dec 31, 2024) or loss to follow up, whichever came first

Study Arms (2)

Day program attendees

Older adults (65+ years) attending an adult day program in Alberta, British Columbia, or Manitoba

Other: Adult day program use

Non-attendees

Older adults with an initial Resident Assessment Instrument - Home Care (RAI-HC), who are not attending a day program in Alberta, British Columbia, or Manitoba

Other: Other community care (non-attendees)

Interventions

Adult day program use OTHER

Day program use patterns will be determined, using Latent Class Analysis. Three continuous variables will be categorized as low, low-moderate, high-moderate, high, using sample distribution quartiles: (1) Time between first RAI-HC assessment and first attendance of a day program, (2) average number of hours of day program attendance (i.e., total number of hours spent in a day program divided by the number of times attended), and (3) total number of days a person attended a day program.

Day program attendees

Other community care (non-attendees) OTHER

Any publicly funded continuing care services in the community, other than adult day programming (e.g., home care, in-home respite). Community care participants will be propensity score matched with day program participants, using RAI-HC variables on day program eligibility (to ensure similarity of non-attendees to day program attendees). Matching variables will include: physical functioning, cognition, behavioural symptoms, bladder/bowel continence, availability of a caregiver, and caregiver distress. The investigators will also include variables on health and social characteristics (e.g., age, sex, type/duration of publicly funded community care received before the matching index date, deprivation indices).

Non-attendees

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study focuses on community care systems in Alberta, British Columbia, and Manitoba, all of which assess day program eligibility using comparable processes, criteria, and assessments (i.e. RAI-HC). The yearly average number of completed RAI-HC assessments is \~20,000-30,000 in Alberta, \~34,000-39,000 in British Columbia, and \~10,000 in Manitoba. The estimated number of day program attendees is \>20,000/year (\>200,000 within the study period), each with multiple assessments.

You may qualify if:

• Persons aged 65 years and over
• Initial RAI-HC assessment completed
• Attendance of an adult day program (for cohort 1)
• Receipt of any community-based continuing care services, other than adult day program (cohort 2)

You may not qualify if:

• \- No receipt of any community-based continuing care service

Sponsors & Collaborators

• York University: lead
• Carswell Family Foundation: collaborator
• Alzheimer Society of York Region: collaborator

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MeSH Terms

Conditions

Alzheimer Disease

Condition Hierarchy (Ancestors)

Dementia; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Tauopathies; Neurodegenerative Diseases; Neurocognitive Disorders; Mental Disorders

Study Officials

• Matthias Hoben, PhD

  York University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Matthias Hoben, Dr rer medic

CONTACT

+1 437-335-1338; mhoben@yorku.ca

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor, Helen Carswell Chair in Dementia Care

Study Record Dates

• First Submitted: May 16, 2024
• First Posted: June 3, 2024
• Study Start: March 1, 2025
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): June 30, 2027
• Last Updated: January 24, 2025

Record last verified: 2025-01

Data Sharing

• IPD Sharing: Will not share