title: Diving below the surface of progressive disability: considering compensatory strategies as evidence of sub-clinical disability.
abstract: OBJECTIVE
  To provide a comprehensive review regarding the role of activity and participation compensations within the disablement process, identify directions for future research, and discuss the implications of compensation pertaining to public health initiatives aimed at preventing and reversing disability.
  
  
  METHODS
  This article evaluated how using compensatory strategies to cope with functional deficits reveals important transitions within the disablement process and signifies a unique opportunity to identify early declines in function.
  
  
  RESULTS
  Previous research suggests that (a) adopting compensatory strategies to maintain activity/participation is strongly associated with functional decline and disease severity and significantly predicts the onset of limitations/restrictions; (b) compensation can be reliably quantified; and (c) contextual knowledge about how individuals adapt to functional decline can be used to describe transitions in the disablement process.
  
  
  CONCLUSIONS
  Characterizing subtle adaptations prior to the onset of activity limitations and participation restrictions will not only aid in understanding the complex disablement process but also help inform social services and future prevention strategies. Overall, this article integrates the concept of compensation into the current model of disability and proposes a framework for identifying and interpreting compensatory behavior.
authors.affiliation: Correspondence should be addressed to Todd M. Manini, Department of Aging and Geriatrics, University of Florida, 210 Mowry Road, Gainesville, Gainesville, FL 32611. E-mail: tmanini@aging.ufl.edu.
authors.forename: Torrance J
authors.initials: TJ
authors.lastname: Higgins
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Janelle
authors.forename: Todd M
authors.initials: TM
authors.lastname: Manini
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000375:Aging / Q000473:pathology / Q000502:physiology*; D004185:Disability Evaluation; D018450:Disease Progression; D006801:Humans; D062706:Prodromal Symptoms
keywords: Compensation; ICF; Preclinical disability; Subclinical disability.