Maintaining independence in everyday life among seniors with subjective cognitive complaints

The planned project explores the effects of Real-World Strategy Training (RWST), an individualized intervention designed to promote independence in everyday life, with older adults who identify cognitive complaints. Evidence suggests that 25-50% of community dwelling older adults report cognitive difficulties, such as reduced memory or concentration, in the absence of any diagnosed condition. Cognitive skills are crucial to living independently and performing activities of daily life such as managing finances, medications and schedules. Moreover, adults who report cognitive complaints have an elevated risk of later experiencing more significant cognitive and functional decline including being diagnosed with dementia. With our growing aging population this represents a significant public health issue and signifies an urgent need for interventions that can delay or even reverse cognitive difficulties. To date, many interventions have been proposed to reduce cognitive decline including cognitive training programs and physical activity programs but there is limited evidence that the skills learned are transferred to other aspects of everyday life – we cannot be sure they improve everyday independence. We plan to examine RWST in a randomized controlled trial. Based on our successful pilot study, we hypothesize that this training which combines education on healthy lifestyles and problem solving training to address everyday life difficulties, will be effective in maximizing and maintaining independence of older adults.

Dr. Deirdre Dawson at the Baycrest Centre for Geriatric Care in Toronto is principal investigator and Dr. Feng Xie is a co-investigator and leader in health economic evaluation of this trial.