Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects and Costs of a Day Care Centre Program Designed for People With Dementia - a 24 Month Controlled Study
Brief Summary: Attending day care centres with programs specifically designed for patients with dementia is believed to postpone admittance to nursing home as well as increase quality of life and well-being for both patients and their family caregivers. We aim to investigate to what degree attendance in day care centres with programs for people with dementia is effective for patient and their caregivers whilst also cost efficient for society. The study consists of a quasi-experimental trial with comparison group. 400 patients with dementia, along with a family caregiver, will be included in the trial. Effects will be measured at baseline, after one and two years. Data collection will be made at three levels; at patient level with measures of cognition, depression, quality of life, functioning in activities in daily living, neuropsychiatric symptoms and death; at caregiver level with measures of depression, level of burden and quality of life; and at societal level with measures of nursing home admittance, hospital stays and use of other health resources. Additionally,a qualitative interview study will include 20 dyads from the main trial. The main focus will be on how attending day care centre programs for patients with dementia affect the lives of both patients and caregivers. Five of these dyads will be followed closely throughout the participation period to be used as case examples.


Options:
A: Inclusion Criteria:

* Age of 65 years or more and living at home
* Patients in the day care centre group must have attended the centre for at least four weeks and have been there no longer than nine months
* Dementia of either Alzheimer's type, vascular dementia, dementia with Lewy bodies/Parkinson's disease or a mixture of these types of dementias
* Capacity to give informed consent as judged by the professional caregivers
* A Mini Mental Status Examination (MMSE) score of ≥15
* Having a family carer willing to participate, who see the patients personally at least once a week
* Attending the day care centre program at least twice a week

Exclusion Criteria:

* Having applied for nursing home placement
* Suffering from a serious co-morbid physical disorder with life expectancy less than six months
B: Inclusion Criteria:

Inclusion Criteria for Veterans with dementia include:

* English speaking
* diagnosed with dementia as above
* able to participate in at least two activities of daily living

  * ADLs - bathing
  * dressing
  * grooming
  * toileting
  * transferring from bed to chair
* not currently participating in any other dementia-related intervention.
* If the Veteran with dementia is on any of four classes of psychotropic medications:

  * antidepressant
  * benzodiazepines
  * antipsychotic
  * anti-convulsant
  * an anti-dementia medication (memantine or a cholinesterase inhibitor)
* We will require that he/she have been on a stable dose for 60 days prior to enrollment to minimize possible confounding effects of concomitant medications (the typical time frame used in clinical trials).
* Caregivers of Veterans must be:

  * English speaking
  * self-identify as the primary member of the family caring (hands-on or supervision) for the Veteran and 21 years of age or older (male or female)
  * living with the Veteran
  * accessible by telephone to schedule interview, intervention sessions and follow-up interviews
  * planning to live in area for 8 months (to reduce loss to follow-up)
  * indicate willingness to learn activity use
  * report one or more NPS in the Veteran in the past month
  * not currently participating in any other caregiver-related intervention.
* Finally, we will require that caregivers taking a psychotropic medication (antidepressant, benzodiazepines, antipsychotic, or anti-convulsant) at time of telephone screen be on a stable dose of the medication for 60 days prior to enrollment.

Exclusion Criteria:

* Non English speaking
* Non-Veteran
* No caregiver
* No diagnosis of dementia
C: Inclusion Criteria:

* Patients with dementia (regardless of etiology) diagnosed or suspected by their physician (general practitioner or specialist) and referred to an Alzheimer specialized team
* Patients with Mini Mental State Examination score\> 15
* Patients living at home, in residences for the elderly
* Presence of a non-professional primary caregiver

Exclusion Criteria:

* Patients under 18 years of age;
* Institutionalized or foster care patients;
* Patients who routinely refuse home care;
* Patients with a known severe and unstable general pathology that does not allow patient follow-up;
* Patients already enrolled in another non-drug management trial other than the study;
* Patients whose institutionalization is probable in the short term (within 6 months) or for whom a change of domicile envisaged in the short term and would not allow the carrying out of the follow-up evaluations;
* Patients under tutorship or curatorship, patients unable to express consent;
* Primary caregiver who does not wish to participate in the study or who cannot be available for the follow-up planned for the study;
* Known cognitive deficits or chronic psychosis that do not able patients' follow-up;
* Presence of a primary caregiver with known cognitive or psychiatric disorders (chronic active psychosis) , which doesn't allow the proper conduct of the study;
* Patients who have already benefited from the "occupational" therapy program.
D: Inclusion Criteria:

* aged 65 years or older
* mild to moderate dementia (MMSE 10-24)
* living in the community at maximum of 50 kilometers from the Memory Clinic
* having an informal primary caregiver who was involved in the care for the patient at least once a week

Exclusion Criteria:

* depression: score \> 12 on the Geriatric Depression Scale
* severe behavioral or psychological symptoms in dementia (BPSD) judged by a geriatrician
* severe illnesses, judged by a geriatrician
* no OT goals, determined by the researcher or research assistant
* caregivers having severe illnesses

Answer: A