Psychological adaptation of elderly individuals with non-dementia cognitive impairment: coping behavior and compensatory strategies

The aim of the study is to compare coping behavior patterns and memory-compensation strategies in older adults with objectively identified and subjective cognitive impairments. Materials and methods: the cross-sectional study included 108 participants (23.1% men; median age = 72 years). The examination consisted of an assessment of cognitive functions (Mini-Mental State Examination, Frontal Assessment Battery, Clock Drawing Test, Wechsler Memory Scale, Addenbrooke’s Cognitive Examination) and stress-coping strategies (Ways of Coping Questionnaire). For the analysis of categorical data, the following methods were used: Pearson’s χ² test (for contingency tables), Fisher’s exact test (for small expected frequencies), and the z-test with Bonferroni correction for multiple pairwise comparisons. Statistical analysis of quantitative variables was performed using nonparametric tests at a significance level of p≤0,05. The Spearman correlation coefficient was applied to evaluate correlations.

Results: participants with objective cognitive impairment demonstrated lower scores on all cognitive tests and less frequent use of active, problem-oriented coping strategies compared with individuals reporting only subjective complaints. Increasing age was associated with lower neuropsychological test scores. Higher cognitive functioning correlated positively with the use of planning and self-control strategies. In both groups, external memory compensation techniques—such as notes, lists, and spatial organization—were most commonly applied. Conclusion: the findings indicate that a decline in cognitive resources is accompanied by reduced use of active coping strategies and greater reliance on external memory aids. These patterns reflect adaptive behavior restructuring in late life and provide a basis for further investigation of psychological mechanisms that help maintain autonomy in older adults with cognitive impairment.

1. Vasserman L.I., Ababkov V.A., Trifonova E.A. Sovladanie so stressom: teoriya i psihodiagnostika. SPb.: Rech’; 2010. (In Russ.).

2. Vojtenko R.M., Sakovskaya V.G., Filippova M.P. Izmeneniya psihicheskih processov i metody ih issledovaniya. Znachenie v mediko-social’noj ekspertize: uchebno-metodicheskoe posobie. SPb.: Ajsing; 2012. (In Russ.).

3. Levin OS, Lavrov AYu, Liashenko EA, et al. Validation of the Russian version of the modified Addenbrooke’s Cognitive Examination for Alzheimer’s disease diagnosis. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. Specvypuski. 2015;115(6-2):36–39. https://doi.org/10.17116/jnevro20151156236-39 (In Russ.).

4. Cherdak MA, Mkhitaryan EA, Sharashkina NV, et al. Rasprostranennost’ kognitivnykh rasstroistv u patsientov starshego vozrasta v Rossiyskoy Federatsii. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2024;124(4 suppl 2):5–11. https://doi.org/10.17116/jnevro20241240425 (In Russ.).

5. Yakhno NN, Zakharov VV, Koberskaya NN, et al. Premild (Subjective And Subtle) Cognitive Disorders. Nevrologicheskii zhurnal. 2017;22(4):198–204. https://doi.org/10.18821/1560-9545-2017-22-4-198-204. (In Russ.).

6. Babcock KR, Page JS, Fallon JR, Webb AE. Adult hippocampal neurogenesis in aging and Alzheimer’s disease. Stem Cell Reports. 2021;16(4):681–693. https://doi.org/10.1016/j.stemcr.2021.01.019

7. Berg AI, Wallin A, Nordlund A, Johansson B. Living with stable MCI: experiences among 17 individuals evaluated at a memory clinic. Aging & Mental Health. 2013;17(3):293–299. https://doi.org/10.1080/13607863.2012.751582

8. Brockdorf Y, Morley JE. Editorial: nutrition and dementia. Journal of Nutrition, Health & Aging. 2021;25(5):590–592. https://doi.org/10.1007/s12603-021-1614-6

9. Dubois B, Slachevsky A, Litvan I, Pillon B. The FAB: a frontal assessment battery at bedside.Neurology. 2000;55(11):1621–1626. https://doi.org/10.1212/WNL.55.11.1621

10. Folkman S., Lazarus R.S. Manual for the Ways of Coping Questionnaire. Menlo Park, CA: Mind Garden; 1988.

11. Folstein MF, Folstein SE, McHugh PR. «Mini-mental state»: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 1975;12(3):189–198. https://doi.org/10.1016/0022-3956(75)90026-6

12. Frazer SM, Oyebode JR, Cleary A. How older women who live alone with dementia make sense of their experiences: an interpretative phenomenological analysis. Dementia. 2012;11(5):677–693. https://doi.org/10.1177/1471301211419018

13. Gibson A, Bardach SH, Jicha GA. Identifying adaptive and maladaptive behaviors following a diagnosis of mild cognitive impairment. Alzheimer Disease & Associated Disorders. 2020;34(3):262–266. https://doi.org/10.1097/WAD.0000000000000379

14. Gilhooly KJ, Gilhooly ML, Sullivan MP, et al. A meta-review of stress, coping and interventions in dementia and dementia caregiving. BMC Geriatrics. 2016;16:106. https://doi.org/10.1186/s12877-016-0280-8

15. Global status report on the public health response to dementia [who.int]. WHO; 2021 [cited 11 November 2025]. Available at: https://www.who.int/publications/i/item/9789240033245

16. Hodges JR, Larner AJ. Addenbrooke’s Cognitive Examinations: ACE, ACE-R, ACE-III, ACEapp, and M-ACE. In: Larner A.J., ed. Cognitive Screening Instruments. Cham: Springer; 2017.https://doi.org/10.1007/978-3-319-44775-9_6

17. Imhof L, Wallhagen MI, Mahrer-Imhof R, Monsch AU. Becoming forgetful: how elderly people deal with forgetfulness in everyday life. American Journal of Alzheimer’s Disease & Other Dementias. 2006;21(5):347–353. https://doi.org/10.1177/1533317506292499

18. Wilson RS, Evans DA, Bienias JL, Mendes de Leon CF, Schneider JA, Bennett DA. Proneness to psychological distress is associated with risk of Alzheimer’s disease. Neurology. 2003;61(11):1479-1485. https://doi.org/10.1212/01.wnl.0000096167.56734.59

19. Jiménez-Balado J, Eich TS. GABAergic dysfunction, neural network hyperactivity and memory impairments in human aging and Alzheimer’s disease. Seminars in Cell & Developmental Biology. 2021;116:146–159. https://doi.org/10.1016/j.semcdb.2021.01.005

20. Joosten-Weyn Banningh L, Vernooij-Dassen M, Rikkert MO, Teunisse JP. Mild cognitive impairment: coping with an uncertain label. International Journal of Geriatric Psychiatry. 2008;23(2):148–154. https://doi.org/10.1002/gps.1855

21. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet.;396(10248):413–446. https://doi.org/10.1016/S0140-6736(20)30367-6

22. Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet Standing Commission. Lancet. 2024;404(10452):572–628. https://doi.org/10.1016/S0140-6736(24)01296-0

23. Lindau M, Björk R. Anosognosia and anosodiaphoria in mild cognitive impairment and Alzheimer’s disease. Dementia and Geriatric Cognitive Disorders Extra. 2014;4(3):465–480. https://doi.org/10.1159/000369132

24. Michel JP, Sadana R. «Healthy aging» concepts and measures. Journal of the American Medical Directors Association. 2017;18(6):460–464. https://doi.org/10.1016/j.jamda.2017.03.008

25. Nishiwaki Y, Breeze E, Smeeth L, Bulpitt CJ, Peters R, Fletcher AE. Validity of the Clock-Drawing Test as a screening tool for cognitive impairment in the elderly. American Journal of Epidemiology. 2004;160(8):797–807. https://doi.org/10.1093/aje/kwh288

26. Nygård L, Öhman A. Managing changes in everyday occupations: the experience of persons with Alzheimer’s disease. OTJR: Occupation, Participation and Health. 2002;22(2):70–81. https://doi.org/10.1177/153944920202200204

27. Nygård L, Starkhammar S. Telephone use among noninstitutionalized persons with dementia living alone: mapping out difficulties and response strategies. Scandinavian Journal of Caring Sciences. 2003;17(3):239–249. https://doi.org/10.1046/j.1471-6712.2003.00177.x

28. Petersen RC. Mild cognitive impairment. Continuum (Minneap Minn). 2016;22(2 Dementia):404–418. https://doi.org/10.1212/CON.0000000000000313

29. Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: mild cognitive impairment [RETIRED]: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2018;90(3):126–135. https://doi.org/10.1212/WNL.0000000000004826

30. Risk reduction of cognitive decline and dementia: WHO guidelines [ncbi.nlm.nih.gov]. ncbi.nlm.nih.gov; 20192 [cited 11 November 2025]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK542796/

31. Ross SD, Hofbauer LM, Rodriguez FS. Coping strategies for memory problems in everyday life of people with cognitive impairment and older adults: a systematic review. International Journal of Geriatric Psychiatry. 2022;37(5):e5701. https://doi.org/10.1002/gps.5701

32. Rotenberg S, Sternberg S, Maeir A. Where did I put my glasses? The lived experience of older adults seeking medical help for perceived memory problems. Disability and Rehabilitation. 2020;42(25):3606–3613. https://doi.org/10.1080/09638288.2019.1602849

33. Rowe JW, Kahn RL. Human aging: usual and successful. Science. 1987;237(4811):143–149. https://doi.org/10.1126/science.3299702

34. Rosenzweig ES, Barnes CA. Impact of aging on hippocampal function: plasticity, network dynamics, and cognition. Progress in Neurobiology. 2003;69(3):143–179. https://doi.org/10.1016/S0301-0082(02)00126-0

35. Souchay C. Metamemory in Alzheimer’s disease. Cortex. 2007;43(7):987–1003. https://doi.org/10.1016/S0010-9452(08)70696-8

36. Stockwell-Smith G, Moyle W, Kellett U. The impact of early-stage dementia on community-dwelling care recipient/carer dyads’ capacity to self-manage. Journal of Clinical Nursing. 2019;28(3–4):629–640. https://doi.org/10.1111/jocn.14657

37. US Preventive Services Task Force, Owens D.K., Davidson K.W., et al. Screening for cognitive impairment in older adults: US Preventive Services Task Force recommendation statement. JAMA. 2020;323(8):757–763. https://doi.org/10.1001/jama.2020.0435

38. Wechsler D. The Wechsler Memory Scale–Revised. San Antonio, TX: The Psychological Corporation; 1987.