Adult day programs provide nutritional, health, social, and recreational services for older adults during daytime hours. The heterogeneity of programs, participants, and funding sources creates challenges in defining and measuring participant outcomes of adult day services. There appear to be two main domains of influence that adult day programs can have on participants: physical health functioning and psychosocial well-being. The study of the psychosocial benefits of adult day services to participants has been neglected. The purpose of this article is to review current empirical literature and to propose a new conceptual model for examining the participant outcomes in adult day services programs, taking into consideration the variability in participant needs and program design and delivery. The model includes service elements that are related to psychosocial well-being and physical functioning, and these elements relate to specific physical and psychosocial proximal and distal outcomes. Further areas for research are suggested.

SUMMARYObjective-Although vascular depression has received considerable research attention, relatively little research in this area has focused on minority samples. This study investigated the association between baseline vascular risk factors (VRFs) and risk for elevated depressive symptoms at 2-year follow-up in a sample of 964 individuals without significant depressive symptomotology (CES-D<12) or cognitive impairment (MMSE< 24) at baseline from the Hispanic Established Population for the Epidemiologic Study of the Elderly.Methods-We examined the associations between self-reported baseline vascular risk factors (chest pain, heart attack, stroke, hypertension, diabetes, and smoking) and a composite of these risk factors with elevated depressive symptoms (CES-D ≥ 16) at 2-year follow-up.Results-Seventy-four (7.7%) of the 964 participants without evidence of depression at baseline demonstrated elevated depressive symptoms (CESD ≥ 16) 2 years later. There was an overall pattern of higher rates of elevated depressive symptoms at 2-year follow-up with increasing number of vascular risk factors (0 VRFs = 6.4%, 1 VRF = 5.5%, 2 VRFs = 7.7%, and 3 or more VRFs = 14.7%). After controlling for demographic variables, physical functioning, and other medical conditions, the cumulative vascular risk index was significantly associated with elevated depressive symptoms at 2-year follow-up (p < 0.05).Conclusions-Our results suggest vascular conditions may contribute to risk for depression over time among Mexican American elders, and this is relatively independent of other medical conditions. These findings suggest that depression is an additional long-term complication of these common cardiovascular disorders.

Projected growth in demand for clinical geropsychologists will require expanding the number of qualified geropsychology mentors at all stages of professional development. This special section provides information on mentoring from expert geropsychology mentors who offer their perspectives, and summarize relevant research, on mentoring graduate students, interns and postdoctoral fellows, junior faculty and members of special populations. The present paper provides an introduction to the special section by establishing the need for increased mentoring within clinical geropsychology, presenting results of a survey of mentoring practices and needs, and discussing ways in which the field is responding to the challenge.

The objective is to test feasibility and utility of home-based videos for assessing Parkinson's disease (PD) patients. As part of a clinical trial, patients opted between coming to the study sites or learning to videotape assessments at home. Those opting for at-home filming completed training on videotape techniques. Ten-minute films were taken at 30-minute intervals over 8.5 hours, 2 and 4 weeks after study entry using a protocol covering most items of the UDPRS motor examination and all Rush Dyskinesia Rating Scale items. After each filming, patients marked their ON/OFF status, based on prior training. We determined the number of patients who elected self-taping and the quality of video segments obtained. To assess ON/OFF patient accuracy, we compared the rater's and patient's assessment of ON/OFF at each time point. Of 12 participants, 10 elected self-videotaping and only 1 time point was missed (99.5% taping compliance). All self-recorded video segments were clear with all protocol elements included. With the exception of one missed ON/OFF rating, patient-based self-ratings occurred on time. Rating ON/OFF, UPDRS, and RDRS assessments for 8.5 hours required 170 minutes by the blinded rater. In spite of patient training, mean ON/OFF concordance between rater and patients was only 64%. At home video-based self-recordings are feasible and allow accurate rater-based ON/OFF assessments. In this group of patients with no or mild fluctuations, in spite of pretrial training, patients were inaccurate in separating ON vs. OFF status.

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