Psychosocial Predictors of Everyday Compensatory Strategy Use in Older Adults

Ross Divers, Louisiana State University, Baton Rouge, United States
Luke Miller, Louisiana State University, Baton Rouge, United States
Jared Cherry, Rosalind Franlin University, North Chicago, United States
Matthew Calamia, Louisiana State University, Baton Rouge, United States


Subtle changes in everyday function are observable in cognitively healthy older adults and have been associated with conversion to mild cognitive impairment. It is critical to understand factors associated with preserved everyday functioning. Use of compensatory strategies, behavioral and environmental modifications designed to bypass changes in cognition, are one pathway that may lead to retained functioning. While various psychological (e.g., mood symptoms, cognitive reserve) and demographic (e.g., age, gender) factors have previously been associated with strategy use, relationships are often inconsistent, and relevant psychological factors (e.g., dementia worry) have not been analyzed. Furthermore, it remains unclear if there are differences in rates of strategy usage across different everyday tasks. The current study aimed to address these gaps in the literature by examining various psychosocial predictors of strategy use and rates of strategy use across everyday tasks.

Participants and Methods:

Older adult participants (N = 252; m age = 65.78/4.9; %female = 64.4) were recruited from the online survey platform, Prolific. Frequency of compensatory strategy use during everyday situations was assessed with the Everyday Compensatory Questionnaire. Psychological predictors included dysphoria (Inventory of Depression and Anxiety Symptoms-II), generalized anxiety (Geriatric Anxiety Scale), dementia worry (Dementia Worry Scale), and age-anchored subjective cognitive decline. Sociodemographic predictors included age, gender, years of education, and frequency of early life cognitively stimulating activities.


More dementia worry (r = .22; p < .001) and subjective cognitive decline (r = .21; p < .001) were related to more total frequency of strategy use. When compared against each other in hierarchical regressions, dementia worry remained a significant predictor of strategy use, F(2, 259) = 8.84, p < 001. with an R2 of .06 and an R2 change of .05. While age and early life cognitively stimulating activities were not related to total strategy use, they were related to several subscales. Greater age was associated with more strategy use related to appointment (r = .14; p = .01) and medication (r = .13; p = .02) management, while more cognitive activity in early life was associated with more strategy use related to shopping (r = .12; p = .02), appointment (r = .14; p = .01) and financial (r = .11; p = .05) management. Dysphoria, generalized anxiety, gender, and years of education were not related to strategy use. Strategy use related to appointment management was the most frequently endorsed (m = 2.71) while medication management was the least frequently endorsed (m = 1.57).


Compensatory strategy use may be an intervention target for maintaining everyday functioning in older adults, though psychosocial predictors of use and when older adults are most likely to apply strategies remains understudied. Contrary to prior research, our results demonstrate worry specifically about dementia, rather than generalized negative psychological constructs, is a predictor of strategy use. Additionally, our results show that there is variability in which everyday tasks cognitively healthy older adults tend to employ compensatory strategies. Interventions to increase compensatory strategy use may benefit from considering these factors (e.g., psychoeducation on aging and increasing use of strategies to reduce stigma).

Category: Aging

Keyword 1: everyday functioning
Keyword 2: activities of daily living
Keyword 3: cognitive rehabilitation