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

Abstract

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.

A Mixed-Method Study on Strategies in Everyday Personal Goals among Community-Dwelling Older Adults

“…In older adults with osteoarthritis, individuals who used compensation reported less pain and higher levels of well-being, and those who reported high levels of selection and optimization were less impaired in the instrumental activities of daily living [13]. In turn, higher compensation rates predict better cognitive performance and levels of functional independence in older adults with moderate to low cognitive status [14-17].…”

“…Because resources decline with age, compensation and selection strategies appear more important in maintaining personal goals and satisfying levels of functioning in older than in younger adults, whereas the reverse is true for optimization strategies [6]. Indeed, there is robust evidence that selection supports a major shift in motivational processes with increasing age [18] and that compensation is summoned for both physical and cognitive functioning when dealing with declining resources [4, 14, 15, 19].…”

Rehabilitation of neuropsychological deficits: Compensatory approaches.

“…With these limitations in mind, we recently developed an assessment tool designed to measure a broad range of compensatory strategies used within the context of IADLs, the Everyday Compensation scale (EComp; Farias et al, 2018Farias et al, , 2020. The EComp is a 41-item measure with demonstrated psychometric properties including content, convergent, construct, and predictive validity.…”

A new multidimensional group intervention for cognitive and psychosocial functioning for older adults: Background, content, and process evaluation

“…Since memory problems are the most obvious complaints in older people ( 15 ), most interventions have focused on strengthening the mnemonic function and the implementation of compensatory strategies. Memory Compensation Strategies (MCS) refer to a group of mechanisms through which individuals can continue to perform well in complex tasks despite having experienced deficits or reductions in memory capacity ( 16 ). MCS were incorporated as a key cognitive strategy aiming to train participants to develop effective strategies that support effective information coding ( 17 ).…”