COMPENSATORY TRAINING TO SUPPORT BRAIN HEALTH AND FUNCTIONAL INDEPENDENCE IN OLDER ADULTS WITH SUBJECTIVE COGNITIVE COMPLAINTS

Subtle changes in everyday functioning begin early in the Alzheimer's disease (AD) process, but progress to eventual loss of independence. Providing compensatory training prior to development of frank cognitive impairment is ideal as individuals have the capacity to learn and routinize strategies to forestall the impact of cognitive decline on functional independence. This study evaluated the feasibility of a compensation training program for individuals with subjective cognitive complaints (SCC), an at risk group for dementia. Eight individuals with SCC completed a 10-week group based intervention designed to train older adults in the use of compensatory/supportive tools including use of a paper-based calendar and note-taking system to improve daily functioning and promote engagement in brain health behaviors (physical exercise, cognitively stimulating activities, and stress reduction). Participants rated their cognitive and exercise engagement (minutes/week) pre- and post-intervention, weekly homework adherence was evaluated (percent completed), and feedback regarding was solicited regarding what they liked/did not like and ways to improve the program. Participants reported significantly more cognitive engagement, such as games and volunteer work, following the intervention (M=175.17, SD=28.74) as compared to before the intervention (M=164.46, SD=27.10; t=−2.34, p =.05). Self-reported engagement in exercise activities also improved from pre-test (M = 151.3, SD = 141.91) to post-test (M = 209.43, SD = 106.81), but did not reach significance, likely because participants were reportedly already engaging in the recommended level of weekly exercise prior to the intervention (i.e., 150 minutes). Adherence to the different components of the program was high. Qualitative feedback was generally positive and suggests that participants reported enhanced self-efficacy in utilizing compensatory strategies, and developed a greater sense of accomplishment. Overall, SCC participants were adherent to the intervention, particularly for target brain health behaviors. Further, efficacy was demonstrated by pre- to post-intervention increase in cognitive engagement (significant) and exercise (trending). Finally, participant feedback suggested that the intervention improved their daily functioning and sense of accomplishment. In summary, compensation training for older individuals with SCC represents a promising intervention for improving everyday functioning and brain health.