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REAL-WORLD ASSESSMENT OF FUNCTIONAL ABILITY AND COMPENSATORY STRATEGY USE IN COMMUNITY DWELLING OLDER ADULTS

By Alyssa Mae Weakley

Abstract

Thesis (Ph.D.), Psychology - Clinical, Washington State UniversityCompensatory strategies such as assistive technology, external reminders, and environmental cues may help support everyday functioning and independence in the real-world. Currently, everyday functional ability is most often evaluated in the clinic or a laboratory setting where compensation cannot be observed. The purpose of the present study was to develop an in-home evaluation of everyday activities where naturalistic use of compensatory strategies could be observed and quantified. Fifty community dwelling older adults were recruited. Half were cognitively and medically healthy (n = 25) and half either met criteria for mild cognitive impairment (MCI; n = 8), had lower cognitive performance but did not meet criteria for MCI (n = 9), or had a documented medical or psychological disorder (n = 8). Participants completed a battery of performance-based and cognitive tasks, an activities of daily living questionnaire (also completed by an informant), and a set of semi-structured activities carried out in their own home. Results suggest that declines in cognition and functional ability lead to decline in compensation. Compensation improved task outcome, particularly for prospective memory and household chores tasks, suggesting that traditional measures are unable to fully account for functional performance in the real-world. Cognition emerged as a moderator for the relationship between compensation and task outcome. Older adults primarily used external strategies, environmental cues, assistive technology, and organizational strategies during the real-world tasks. Results also suggest a divergent relationship between informant and self-report of everyday functioning, where participants' ratings were more related to real-world functioning and informants' ratings were more related to performance-based tasks. This study has important clinical evaluation and intervention implication.Washington State University, Psychology - ClinicalBy student request, this dissertation cannot be exposed to search engines and is, therefore, only accessible to Washington State University users

Topics: Psychology, Aging, Cognition, Compensation, Functional Ability
Year: 2018
OAI identifier: oai:research.libraries.wsu.edu:2376/16425
Provided by: Research Exchange
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