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The Lancet. Neurology Nov 2012The concept of cognitive reserve provides an explanation for differences between individuals in susceptibility to age-related brain changes or pathology related to... (Review)
Review
The concept of cognitive reserve provides an explanation for differences between individuals in susceptibility to age-related brain changes or pathology related to Alzheimer's disease, whereby some people can tolerate more of these changes than others and maintain function. Epidemiological studies suggest that lifelong experiences, including educational and occupational attainment, and leisure activities in later life, can increase this reserve. For example, the risk of developing Alzheimer's disease is reduced in individuals with higher educational or occupational attainment. Reserve can conveniently be divided into two types: brain reserve, which refers to differences in the brain structure that may increase tolerance to pathology, and cognitive reserve, which refers to differences between individuals in how tasks are performed that might enable some people to be more resilient to brain changes than others. Greater understanding of the concept of cognitive reserve could lead to interventions to slow cognitive ageing or reduce the risk of dementia.
Topics: Aging; Alzheimer Disease; Animals; Cognitive Reserve; Humans
PubMed: 23079557
DOI: 10.1016/S1474-4422(12)70191-6 -
Journal of Biomedical Science May 2019Alzheimer's disease (AD) is the most common type of dementia and typically manifests through a progressive loss of episodic memory and cognitive function, subsequently... (Review)
Review
Alzheimer's disease (AD) is the most common type of dementia and typically manifests through a progressive loss of episodic memory and cognitive function, subsequently causing language and visuospatial skills deficiencies, which are often accompanied by behavioral disorders such as apathy, aggressiveness and depression. The presence of extracellular plaques of insoluble β-amyloid peptide (Aβ) and neurofibrillary tangles (NFT) containing hyperphosphorylated tau protein (P-tau) in the neuronal cytoplasm is a remarkable pathophysiological cause in patients' brains. Approximately 70% of the risk of developing AD can be attributed to genetics. However, acquired factors such as cerebrovascular diseases, diabetes, hypertension, obesity and dyslipidemia increase the risk of AD development. The aim of the present minireview was to summarize the pathophysiological mechanism and the main risk factors for AD. As a complement, some protective factors associated with a lower risk of disease incidence, such as cognitive reserve, physical activity and diet will also be addressed.
Topics: Aged; Aged, 80 and over; Alzheimer Disease; Cognitive Reserve; Diet; Exercise; Humans; Incidence; Middle Aged; Protective Factors; Risk Factors
PubMed: 31072403
DOI: 10.1186/s12929-019-0524-y -
Current Neurology and Neuroscience... Jan 2019The aim of this review is to summarize current conceptual models of cognitive reserve (CR) and related concepts and to discuss evidence for these concepts within the... (Review)
Review
PURPOSE OF REVIEW
The aim of this review is to summarize current conceptual models of cognitive reserve (CR) and related concepts and to discuss evidence for these concepts within the context of aging and Alzheimer's disease.
RECENT FINDINGS
Evidence to date supports the notion that higher levels of CR, as measured by proxy variables reflective of lifetime experiences, are associated with better cognitive performance, and with a reduced risk of incident mild cognitive impairment/dementia. However, the impact of CR on longitudinal cognitive trajectories is unclear and may be influenced by a number of factors. Although there is promising evidence that some proxy measures of CR may influence structural brain measures, more research is needed. The protective effects of CR may provide an important mechanism for preserving cognitive function and cognitive well-being with age, in part because it can be enhanced throughout the lifespan. However, more research on the mechanisms by which CR is protective is needed.
Topics: Aged; Aging; Alzheimer Disease; Brain; Cognition; Cognitive Aging; Cognitive Dysfunction; Cognitive Reserve; Humans
PubMed: 30627880
DOI: 10.1007/s11910-019-0917-z -
Alzheimer's & Dementia : the Journal of... Sep 2020Several concepts, which in the aggregate get might be used to account for "resilience" against age- and disease-related changes, have been the subject of much research.... (Review)
Review
Several concepts, which in the aggregate get might be used to account for "resilience" against age- and disease-related changes, have been the subject of much research. These include brain reserve, cognitive reserve, and brain maintenance. However, different investigators have use these terms in different ways, and there has never been an attempt to arrive at consensus on the definition of these concepts. Furthermore, there has been confusion regarding the measurement of these constructs and the appropriate ways to apply them to research. Therefore the reserve, resilience, and protective factors professional interest area, established under the auspices of the Alzheimer's Association, established a whitepaper workgroup to develop consensus definitions for cognitive reserve, brain reserve, and brain maintenance. The workgroup also evaluated measures that have been used to implement these concepts in research settings and developed guidelines for research that explores or utilizes these concepts. The workgroup hopes that this whitepaper will form a reference point for researchers in this area and facilitate research by supplying a common language.
Topics: Aging; Alzheimer Disease; Brain; Cognitive Reserve; Guidelines as Topic; Humans; Research Design
PubMed: 30222945
DOI: 10.1016/j.jalz.2018.07.219 -
Trends in Cognitive Sciences May 2021Cognitive reserve is characterized by a dissociation between cognitive level and brain structure, thereby reducing the impact of deteriorating brain structure on... (Review)
Review
Cognitive reserve is characterized by a dissociation between cognitive level and brain structure, thereby reducing the impact of deteriorating brain structure on cognitive function. Cognitive reserve is therefore a promising approach to maintaining cognitive function and protecting against symptoms of dementia. The present paper evaluates evidence supporting the claim that bilingualism contributes to cognitive reserve. Four types of evidence are presented: (i) brain and cognitive function in healthy aging, (ii) age of onset of symptoms of dementia, (iii) relation between clinical level and neuropathology for patients, and (iv) rate of cognitive decline in later stages of dementia. In all cases, bilinguals revealed patterns that were consistent with the interpretation of protection from cognitive reserve when compared with monolinguals.
Topics: Brain; Cognition; Cognitive Dysfunction; Cognitive Reserve; Humans; Multilingualism
PubMed: 33771449
DOI: 10.1016/j.tics.2021.02.003 -
Psychological Science in the Public... Aug 2020Cognitive abilities are important predictors of educational and occupational performance, socioeconomic attainment, health, and longevity. Declines in cognitive... (Review)
Review
Cognitive abilities are important predictors of educational and occupational performance, socioeconomic attainment, health, and longevity. Declines in cognitive abilities are linked to impairments in older adults' everyday functions, but people differ from one another in their rates of cognitive decline over the course of adulthood and old age. Hence, identifying factors that protect against compromised late-life cognition is of great societal interest. The number of years of formal education completed by individuals is positively correlated with their cognitive function throughout adulthood and predicts lower risk of dementia late in life. These observations have led to the propositions that prolonging education might (a) affect cognitive ability and (b) attenuate aging-associated declines in cognition. We evaluate these propositions by reviewing the literature on educational attainment and cognitive aging, including recent analyses of data harmonized across multiple longitudinal cohort studies and related meta-analyses. In line with the first proposition, the evidence indicates that educational attainment has positive effects on cognitive function. We also find evidence that cognitive abilities are associated with selection into longer durations of education and that there are common factors (e.g., parental socioeconomic resources) that affect both educational attainment and cognitive development. There is likely reciprocal interplay among these factors, and among cognitive abilities, during development. Education-cognitive ability associations are apparent across the entire adult life span and across the full range of education levels, including (to some degree) tertiary education. However, contrary to the second proposition, we find that associations between education and aging-associated cognitive declines are negligible and that a threshold model of dementia can account for the association between educational attainment and late-life dementia risk. We conclude that educational attainment exerts its influences on late-life cognitive function primarily by contributing to individual differences in cognitive skills that emerge in early adulthood but persist into older age. We also note that the widespread absence of educational influences on rates of cognitive decline puts constraints on theoretical notions of cognitive aging, such as the concepts of cognitive reserve and brain maintenance. Improving the conditions that shape development during the first decades of life carries great potential for improving cognitive ability in early adulthood and for reducing public-health burdens related to cognitive aging and dementia.
Topics: Academic Success; Cognition; Cognitive Aging; Cognitive Dysfunction; Cognitive Reserve; Dementia; Educational Status; Humans; Risk Factors
PubMed: 32772803
DOI: 10.1177/1529100620920576 -
BMC Geriatrics Oct 2018The Montreal Cognitive Assessment (MoCA) is known to have discriminative power for patients with Mild Cognitive Impairment (MCI). Recently Cognitive Reserve (CR) has...
BACKGROUND
The Montreal Cognitive Assessment (MoCA) is known to have discriminative power for patients with Mild Cognitive Impairment (MCI). Recently Cognitive Reserve (CR) has been introduced as a factor that compensates cognitive decline. We aimed to assess whether the MoCA reflects CR. Furthermore, we assessed whether there were any differences in the efficacy between the MoCA and the Mini-Mental State Examination (MMSE) in reflecting CR.
METHODS
MoCA, MMSE, and the Cognitive Reserve Index questionnaire (CRIq) were administered to 221 healthy participants. Normative data and associated factors of the MoCA were identified. Correlation and regression analyses of the MoCA, MMSE and CRIq scores were performed, and the MoCA score was compared with the MMSE score to evaluate the degree to which the MoCA reflected CR.
RESULTS
The MoCA reflected total CRIq score (CRI; B = 0.076, P < 0.001), CRI-Education (B = 0.066, P < 0.001), and CRI-Working activity (B = 0.025, P = 0.042), while MMSE reflected total CRI (B = 0.044, P < 0.001) and CRI-Education (B = 0.049, P < 0.001) only. The MoCA differed from the MMSE in the reflection of total CRI (Z = 2.30).
CONCLUSION
In this study, we show that the MoCA score reflects CR more sensitively than the MMSE score. Therefore, we suggest that MoCA can be used to assess CR and early cognitive decline.
Topics: Aged; Aged, 80 and over; Cognitive Dysfunction; Cognitive Reserve; Female; Humans; Male; Mental Status and Dementia Tests; Middle Aged; Neuropsychological Tests
PubMed: 30376815
DOI: 10.1186/s12877-018-0951-8 -
Neuropsychology Review Jun 2021Cognitive reserve (CR) may reduce the risk of dementia. We summarized the effect of CR on progression to mild cognitive impairment (MCI) or dementia in studies... (Meta-Analysis)
Meta-Analysis Review
Cognitive reserve (CR) may reduce the risk of dementia. We summarized the effect of CR on progression to mild cognitive impairment (MCI) or dementia in studies accounting for Alzheimer's disease (AD)-related structural pathology and biomarkers. Literature search was conducted in Web of Science, PubMed, Embase, and PsycINFO. Relevant articles were longitudinal, in English, and investigating MCI or dementia incidence. Meta-analysis was conducted on nine articles, four measuring CR as cognitive residual of neuropathology and five as composite psychosocial proxies (e.g., education). High CR was related to a 47% reduced relative risk of MCI or dementia (pooled-hazard ratio: 0.53 [0.35, 0.81]), with residual-based CR reducing risk by 62% and proxy-based CR by 48%. CR protects against MCI and dementia progression above and beyond the effect of AD-related structural pathology and biomarkers. The finding that proxy-based measures of CR rivaled residual-based measures in terms of effect on dementia incidence underscores the importance of early- and mid-life factors in preventing dementia later.
Topics: Alzheimer Disease; Cognitive Dysfunction; Cognitive Reserve; Disease Progression; Humans
PubMed: 33415533
DOI: 10.1007/s11065-021-09478-4 -
Ageing Research Reviews Feb 2022This systematic review aims to summarize cognitive reserve (CR) evaluation approaches and to examine the role of seven selected modifiable lifestyle factors (diet,... (Review)
Review
This systematic review aims to summarize cognitive reserve (CR) evaluation approaches and to examine the role of seven selected modifiable lifestyle factors (diet, smoking, alcohol consumption, physical activity, cognitive leisure activity, sleep, and meditation) in mitigating the impacts of age- or disease-related brain changes on cognition. Eighteen population-based English empirical studies were included. We summarize the study designs and identify three CR models that were broadly used in these studies, including a residual model assessing lifestyle factors in relation to unexplained variance in cognition after accounting for brain markers, a moderation model testing whether lifestyle factors moderate the relationship between brain status and cognition, and a controlling model examining the associations between lifestyle factors and cognition when controlling for brain measures. We also present the findings for the impact of each lifestyle factor. No studies examined diet, sleep, or meditation, and only two studies focused on smoking and alcohol consumption each. Overall, the studies suggest lifestyle activity factors (physical and cognitive leisure activities) may contribute to CR and attenuate the damaging impact of brain changes on cognition. Standardized measurements of lifestyle factors and CR are needed, and mechanisms underlying CR need to be further addressed as well.
Topics: Brain; Cognition; Cognitive Reserve; Exercise; Humans; Life Style
PubMed: 34952208
DOI: 10.1016/j.arr.2021.101551 -
Neurobiology of Aging Nov 2019Significant individual differences in the trajectories of cognitive aging and in age-related changes of brain structure and function have been reported in the past... (Review)
Review
Significant individual differences in the trajectories of cognitive aging and in age-related changes of brain structure and function have been reported in the past half-century. In some individuals, significant pathological changes in the brain are observed in conjunction with relatively well-preserved cognitive performance. Multiple constructs have been invoked to explain this paradox of resilience, including brain reserve, cognitive reserve, brain maintenance, and compensation. The aim of this session of the Cognitive Aging Summit III was to examine the overlap and distinctions in definitions and measurement of these constructs, to discuss their neural and behavioral correlates and to propose plausible mechanisms of individual cognitive resilience in the face of typical age-related neural declines.
Topics: Aging; Brain; Cognition; Cognitive Aging; Cognitive Reserve; Humans; Individuality
PubMed: 31732015
DOI: 10.1016/j.neurobiolaging.2019.03.022