A - 13Who Knows Best? Reliability of Informant- and Self-Reported Compensatory Strategies for Everyday Medication Use in Community-Dwelling Older Adults

Chudoba, Lisa A.; Weakley, Andrew T.; Schmitter‐Edgecombe, Maureen

doi:10.1093/arclin/acy061.13

Cited by 2 publications

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“…Future work should also compare informant and self-reported compensation to more objective and real-world measures of compensation. Recent preliminary data suggest that subjective and objective measures of compensation are related (Chudoba et al, 2018). Our analyses may also have been limited by the measure of executive function used.…”

Section: Discussionmentioning

confidence: 97%

The Everyday Compensation (EComp) Questionnaire: Construct Validity and Associations with Diagnosis and Longitudinal Change in Cognition and Everyday Function in Older Adults

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Weakley

et al. 2019

J Int Neuropsychol Soc

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Objective:The Everyday Compensation scale (EComp) is an informant-rated questionnaire designed to measure cognitively based compensatory strategies that support both everyday memory and executive function in the context of completing instrumental activities of daily living (IADLs). Although previous findings provided early support for the usefulness of the initial version of EComp, the current paper further describes the development, refinement, and validation of EComp as a new assessment tool of compensation for IADLs.Method:Confirmatory factor analysis (CFA) was used to examine its factor structure. Convergent and predictive validity was evaluated by examining the relationship between EComp and markers of disease, including diagnosis, cognitive change, and trajectories of functional abilities.Results:CFA supported a general compensation factor after accounting for variance attributable to IADL domain-specific engagement. The clinical groups differed in compensatory strategy use, with those with dementia using significantly fewer compensatory strategies as compared to individuals with normal cognition or mild cognitive impairment. Greater levels of compensation were related to better cognitive functions (memory and executive function) and functional abilities, as well as slower rates of cognitive and functional decline over time. Importantly, higher levels of compensation were associated with less functional difficulties and subsequently slower rate of functional decline independent of the level of cognitive impairment.Conclusions:Engagement in compensatory strategies among older adults has important implications for prolonging functional independence, even in those with declining cognitive functioning. Results suggest that the revised EComp is likely to be useful in measuring cognitively based compensation in older adults.

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Section: Discussionmentioning

confidence: 97%

The Everyday Compensation (EComp) Questionnaire: Construct Validity and Associations with Diagnosis and Longitudinal Change in Cognition and Everyday Function in Older Adults

Farias

Gravano

Weakley

et al. 2019

J Int Neuropsychol Soc

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Compensatory strategy use improves real-world functional performance in community dwelling older adults.

Weakley¹,

Schmitter‐Edgecombe²

2019

Neuropsychology

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Objective: Compensatory strategies such as assistive technology, external reminders, and environmental cues may help support instrumental activities of daily living (IADLs) and independence. However, functional ability is most often evaluated in clinical settings where everyday compensation cannot be readily observed. The present study used a novel, real-world evaluation of everyday activities (prospective memory, household chores, complex IADLs, and planning tasks) to examine the impact of compensation. Method: Fifty community dwelling older adults were recruited with cognitive status ranging from healthy to mildly impaired. Participants completed a battery of validated performancebased and cognitive tasks, an IADL questionnaire (also completed by an informant), and real-world activities carried out in their own homes. Results: The real-world evaluation demonstrated adequate interrater reliability (intraclass coefficient ϭ 0.92) and construct validity (r ϭ 0.55). Compensation improved real-world task outcome on prospective memory and household chores tasks. Further, cognition emerged as a moderator between compensation and prospective memory task outcome. Participants' ratings on an IADL questionnaire were related to real-world and performance-based functioning whereas informants' ratings were related to performance-based tasks and cognition. Conclusions: Our results suggest that proxy measures of functional ability (i.e., performance-based, cognitive, and IADL questionnaire measures) do not fully capture the complexity of real-world performance for nondemented community dwelling older adults. Compensation appeared to improve prospective memory performance, particularly for individuals with average to low average cognitive abilities. A difference in IADL questionnaire ratings suggest that participants may be better able to judge their real-world performance than informants.

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A - 13Who Knows Best? Reliability of Informant- and Self-Reported Compensatory Strategies for Everyday Medication Use in Community-Dwelling Older Adults

Cited by 2 publications

References 0 publications

The Everyday Compensation (EComp) Questionnaire: Construct Validity and Associations with Diagnosis and Longitudinal Change in Cognition and Everyday Function in Older Adults

The Everyday Compensation (EComp) Questionnaire: Construct Validity and Associations with Diagnosis and Longitudinal Change in Cognition and Everyday Function in Older Adults

Compensatory strategy use improves real-world functional performance in community dwelling older adults.

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