How should proxies of cognitive reserve be evaluated in a population of healthy older adults?

ABSTRACTBackground:While some tools have been developed to estimate an individual's cognitive reserve (CR), no study has assessed the adequacy of the method used for assessing these CR proxy indicators. Therefore, we aimed to determine the most appropriate method to estimate CR by comparing two approaches: (1) the common assessment of CR proxies in the literature (e.g. years of education) and (2) the calculation of a comprehensive index based on most significant parameters used in the estimation of CR.Methods:Data on CR proxies (i.e. education, occupation, and leisure activities) were obtained in a sample of 204 older adults. Regression analyses were used to develop the two indices of CR (i.e. ICR-standard and ICR-detailed) and to determine which index best represented the level of one's CR.Results:The ICR-standard was calculated using a combination of the three most common measures of reserve in the literature: number of schooling years, complexity of the primary occupation, and amount of current participation in stimulating activities. The ICR-detailed was calculated using the most significant parameters (established in initial analyses) of CR: highest level of education combined with the number of training courses, last occupation, and amount of current participation in social and intellectual activities. The comparison of both indices showed that higher levels of ICR-standard and ICR-detailed were associated with a greater minimization of the effects of age on cognition. However, the ICR-detailed was more strongly associated to this minimization than the ICR-standard, suggesting that the ICR-detailed best reflect one's CR.Conclusions:This study is the first to show that it is of great importance to question methods measuring CR proxies in order to develop a clinical tool allowing a comprehensive and accurate estimation of CR.

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Cognitive Improvement in Healthy Older Adults Can Parallel That of Younger Adults Following Lifestyle Modification: Support for Cognitive Reserve During Aging

Journal of Alzheimer s Disease Reports ◽

10.3233/adr-180056 ◽

2018 ◽

Vol 2 (1) ◽

pp. 201-205 ◽

Cited By ~ 1

Author(s):

Thomas B. Shea ◽

Ruth Remington

Keyword(s):

Older Adults ◽

Cognitive Reserve ◽

Lifestyle Modification ◽

Younger Adults ◽

Healthy Older Adults ◽

Cognitive Improvement

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Harmonisation and Between-Country Differences of the Lifetime of Experiences Questionnaire in Older Adults

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.740005 ◽

2021 ◽

Vol 13 ◽

Author(s):

Valentin Ourry ◽

Natalie L. Marchant ◽

Ann-Katrin Schild ◽

Nina Coll-Padros ◽

Olga M. Klimecki ◽

...

Keyword(s):

Older Adults ◽

Life Course ◽

Cognitive Reserve ◽

Leisure Activities ◽

International Comparisons ◽

Education Systems ◽

Promising Tool ◽

Behavioural Determinants ◽

Country Differences ◽

The Life Course

Background: The Lifetime of Experiences Questionnaire (LEQ) assesses complex mental activity across the life-course and has been associated with brain and cognitive health. The different education systems and occupation classifications across countries represent a challenge for international comparisons. The objectives of this study were four-fold: to adapt and harmonise the LEQ across four European countries, assess its validity across countries, explore its association with brain and cognition and begin to investigate between-country differences in life-course mental activities.Method: The LEQ was administered to 359 cognitively unimpaired older adults (mean age and education: 71.2, 13.2 years) from IMAP and EU-funded Medit-Ageing projects. Education systems, classification of occupations and scoring guidelines were adapted to allow comparisons between France, Germany, Spain and United Kingdom. We assessed the LEQ's (i) concurrent validity with a similar instrument (cognitive activities questionnaire - CAQ) and its structural validity by testing the factors' structure across countries, (ii) we investigated its association with cognition and neuroimaging, and (iii) compared its scores between countries.Results: The LEQ showed moderate to strong positive associations with the CAQ and revealed a stable multidimensional structure across countries that was similar to the original LEQ. The LEQ was positively associated with global cognition. Between-country differences were observed in leisure activities across the life-course.Conclusions: The LEQ is a promising tool for assessing the multidimensional construct of cognitive reserve and can be used to measure socio-behavioural determinants of cognitive reserve in older adults across countries. Longitudinal studies are warranted to test further its clinical utility.

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[P3-471]: THE ENGAGE PROGRAM: COMBINING COGNITIVE TRAINING WITH ENGAGING LEISURE ACTIVITIES TO PROMOTE COGNITIVE RESERVE IN OLDER ADULTS AT RISK OF DEMENTIA

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.06.1689 ◽

2017 ◽

Vol 13 (7S_Part_24) ◽

pp. P1156-P1156

Author(s):

Sylvie Belleville ◽

Keyword(s):

Older Adults ◽

At Risk ◽

Cognitive Training ◽

Cognitive Reserve ◽

Leisure Activities

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Cognitive Reserve and Social Capital Accrued in Early and Midlife Moderate the Relation of Psychological Stress to Cognitive Performance in Old Age

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000488052 ◽

2018 ◽

Vol 45 (3-4) ◽

pp. 190-197 ◽

Cited By ~ 10

Author(s):

Andreas Ihle ◽

Michel Oris ◽

Julia Sauter ◽

Ulrike Rimmele ◽

Matthias Kliegel

Keyword(s):

Older Adults ◽

Social Capital ◽

Cognitive Performance ◽

Old Age ◽

Psychological Stress ◽

Processing Speed ◽

Cognitive Reserve ◽

Leisure Activities ◽

Cognitive Level ◽

Verbal Abilities

Aims: The present study set out to investigate the relation of psychological stress to cognitive performance and its interplay with key life course markers of cognitive reserve and social capital in a large sample of older adults. Methods: We assessed cognitive performance (verbal abilities and processing speed) and psychological stress in 2,812 older adults. The Participants reported information on education, occupation, leisure activities, family, and close friends. Results: Greater psychological stress was significantly related to lower performance in verbal abilities and processing speed. Moderation analyses suggested that the relations of psychological stress to cognitive performance were reduced in individuals with higher education, a higher cognitive level of the first profession practiced after education, a larger number of midlife leisure activities, a larger number of significant family members, and a larger number of close friends. Conclusion: Cognitive reserve and social capital accrued in early and midlife may reduce the detrimental influences of psychological stress on cognitive functioning in old age.

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Verbal intelligence is a more robust cross-sectional measure of cognitive reserve than level of education in healthy older adults

Alzheimer s Research & Therapy ◽

10.1186/s13195-021-00870-z ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

R. Boyle ◽

S. P. Knight ◽

C. De Looze ◽

D. Carey ◽

S. Scarlett ◽

...

Keyword(s):

Older Adults ◽

Executive Function ◽

Cognitive Function ◽

Brain Structure ◽

Cognitive Reserve ◽

Cognitive Outcome ◽

Verbal Intelligence ◽

Cross Sectional ◽

Healthy Older Adults ◽

Occupational Complexity

Abstract Background Cognitive reserve is most commonly measured using socio-behavioural proxy variables. These variables are easy to collect, have a straightforward interpretation, and are widely associated with reduced risk of dementia and cognitive decline in epidemiological studies. However, the specific proxies vary across studies and have rarely been assessed in complete models of cognitive reserve (i.e. alongside both a measure of cognitive outcome and a measure of brain structure). Complete models can test independent associations between proxies and cognitive function in addition to the moderation effect of proxies on the brain-cognition relationship. Consequently, there is insufficient empirical evidence guiding the choice of proxy measures of cognitive reserve and poor comparability across studies. Method In a cross-sectional study, we assessed the validity of 5 common proxies (education, occupational complexity, verbal intelligence, leisure activities, and exercise) and all possible combinations of these proxies in 2 separate community-dwelling older adult cohorts: The Irish Longitudinal Study on Ageing (TILDA; N = 313, mean age = 68.9 years, range = 54–88) and the Cognitive Reserve/Reference Ability Neural Network Study (CR/RANN; N = 234, mean age = 64.49 years, range = 50–80). Fifteen models were created with 3 brain structure variables (grey matter volume, hippocampal volume, and mean cortical thickness) and 5 cognitive variables (verbal fluency, processing speed, executive function, episodic memory, and global cognition). Results No moderation effects were observed. There were robust positive associations with cognitive function, independent of brain structure, for 2 individual proxies (verbal intelligence and education) and 16 composites (i.e. combinations of proxies). Verbal intelligence was statistically significant in all models. Education was significant only in models with executive function as the cognitive outcome variable. Three robust composites were observed in more than two-thirds of brain-cognition models: the composites of (1) occupational complexity and verbal intelligence, (2) education and verbal intelligence, and (3) education, occupational complexity, and verbal intelligence. However, no composite had larger average effects nor was more robust than verbal intelligence alone. Conclusion These results support the use of verbal intelligence as a proxy measure of CR in cross-sectional studies of cognitively healthy older adults.

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Validation of a Dynamic Measure of Current Cognitive Reserve in a Longitudinally Assessed Sample of Healthy Older Adults: The Tasmanian Healthy Brain Project

Assessment ◽

10.1177/1073191116685806 ◽

2017 ◽

Vol 26 (4) ◽

pp. 737-742 ◽

Cited By ~ 1

Author(s):

Mathew J. Summers ◽

Megan E. Thow ◽

David D. Ward ◽

Nichole L. Saunders ◽

Shannon Z. Klekociuk ◽

...

Keyword(s):

Older Adults ◽

Cognitive Reserve ◽

Healthy Older Adults

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Verbal intelligence is a more robust cross-sectional measure of cognitive reserve than level of education in healthy older adults

10.21203/rs.3.rs-216364/v2 ◽

2021 ◽

Author(s):

Rory Boyle ◽

Silvin P Knight ◽

Céline De Looze ◽

Daniel Carey ◽

Siobhan Scarlett ◽

...

Keyword(s):

Older Adults ◽

Executive Function ◽

Cognitive Function ◽

Brain Structure ◽

Cognitive Reserve ◽

Cognitive Outcome ◽

Verbal Intelligence ◽

Cross Sectional ◽

Healthy Older Adults ◽

Occupational Complexity

Abstract BackgroundCognitive reserve is most commonly measured using socio-behavioural proxy variables. These variables are easy to collect, have a straightforward interpretation, and are widely associated with reduced risk of dementia and cognitive decline in epidemiological studies. However, the specific proxies vary across studies and have rarely been assessed in complete models of cognitive reserve (i.e., alongside both a measure of cognitive outcome and a measure of brain structure). Complete models can test independent associations between proxies and cognitive function in addition to the moderation effect of proxies on the brain-cognition relationship. Consequently, there is insufficient empirical evidence guiding the choice of proxy measures of cognitive reserve and poor comparability across studies.MethodIn a cross-sectional study, we assessed the validity of 5 common proxies (education, occupational complexity, verbal intelligence, leisure activities, and exercise) and all possible combinations of these proxies in 2 separate community-dwelling older adult cohorts: The Irish Longitudinal Study on Ageing (TILDA; N = 313, mean age = 68.9 years, range = 54–88) and the Cognitive Reserve/Reference Ability Neural Network Study (CR/RANN; N = 234, mean age = 64.49 years, range = 50–80). 15 models were created with 3 brain structure variables (grey matter volume, hippocampal volume, and mean cortical thickness) and 5 cognitive variables (verbal fluency, processing speed, executive function, episodic memory, and global cognition).ResultsNo moderation effects were observed. There were robust positive associations with cognitive function, independent of brain structure, for 2 individual proxies (verbal intelligence and education), and 16 composites (i.e., combinations of proxies). Verbal intelligence was statistically significant in all models. Education was significant only in models with executive function as the cognitive outcome variable. Three robust composites were observed in more than two thirds of brain-cognition models: the composites of 1) occupational complexity and verbal intelligence, 2) education and verbal intelligence, and 3) education, occupational complexity and verbal intelligence. However, no composite had larger average effects nor was more robust than verbal intelligence alone.ConclusionThese results support the use of verbal intelligence as a proxy measure of CR in cross-sectional studies of cognitively healthy older adults.

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Musical Leisure Activities to Support Cognitive and Emotional Functioning in Aging and Dementia

Music and Dementia ◽

10.1093/oso/9780190075934.003.0006 ◽

2019 ◽

pp. 103-121

Author(s):

Teppo Särkämö

Keyword(s):

Older Adults ◽

Social Interaction ◽

Leisure Activities ◽

Well Being ◽

Brain Regions ◽

Healthy Older Adults ◽

Promising Tool ◽

The Everyday ◽

Neurocognitive Aging ◽

Neurological Illnesses

The capacity of music to engage auditory, cognitive, motor, and emotional functions across cortical and subcortical brain regions and the relative preservation of music in the aging and degenerating brain makes music a promising tool both in supporting healthy neurocognitive aging and maintaining better emotional well-being, cognitive functioning, and communication and social interaction in different stages of dementia. As the incidence and prevalence of aging-related neurological illnesses is rapidly increasing, it is important to develop music-based interventions that make use of self- or caregiver-implemented musical leisure activities and that are enjoyable and effective in the everyday care of the persons with dementia. This chapter reviews recent experimental evidence on the emotional and cognitive effects of musical leisure activities in healthy older adults and in persons with dementia and their caregivers. The chapter also discusses which factors are crucial for the efficacy of music in different stages of dementia.

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Sleep-Wake Disturbances and Episodic Memory in Older Adults

Biological Research For Nursing ◽

10.1177/1099800420941601 ◽

2020 ◽

pp. 109980042094160

Author(s):

An-Yun Yeh ◽

Susan J. Pressler ◽

Donna Algase ◽

Laura M. Struble ◽

Bunny J. Pozehl ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Episodic Memory ◽

Cognitive Reserve ◽

Verbal Learning ◽

Memory Loss ◽

Correlation Coefficients ◽

Healthy Older Adults ◽

Learning Test ◽

The Relationship

Sleep-wake disturbances have been associated with episodic memory loss, but past studies were limited by use of single measures of objective or perceived disturbances. Notably, cognitive reserve and depressive symptoms have been associated with sleep-wake disturbances and poorer episodic memory in older adults. The aims of this study were to determine the relationship between episodic memory and sleep-wake disturbances using objective and perceived measures in older adults and to examine cognitive reserve and depressive symptoms as moderators of this relationship. In this descriptive study, 62 healthy older adults (mean age: 69.9 years; 75.8% women) were recruited from the University of Michigan Clinical Research Program. Objective sleep-wake disturbances were measured by 7-day actigraphy and perceived sleep-wake disturbances by the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. Episodic memory was measured by the Hopkins Verbal Learning Test-Revised. Analyses involved Pearson’s correlation coefficients and hierarchical multiple regression. Results showed that more objectively measured sleep disruption was associated with poorer episodic memory and more perceived daytime sleepiness was associated with better episodic memory. Cognitive reserve and depressive symptoms were not moderators of this relationship. In this study, the relationship between sleep-wake disturbances and episodic memory differed by type of measure, objective or perceived. Future studies are needed using multiple measures of episodic memory to further understand the sleep-wake disturbances and episodic memory relationship in a larger diverse sample of healthy older adults.

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