THE COGNITIVE RESERVE PARADOX: COGNITIVE ENGAGEMENT IN MIDLIFE PREDICTS MORE RAPID COGNITIVE DECLINE IN LATE LIFE

Abstract. A decline in cognitive functioning is part of physiological aging. Accelerated cognitive decline is frequently linked to pathological changes, mostly due to Alzheimer’s Disease (AD), but is present also in Mild Cognitive Impairment (MCI) which is a predictor of transition to dementia. This review aims to summarize possible preventive biological and psychological treatments in different stages of lifespan to avoid more rapid cognitive decline and prevent pathological aging. Psychophysiological approaches aim to prevent brain damage and inflammation, two factors playing probably a major role in middle and old age. Interventions on working memory and imagery, using “cognitive reserve,” are beneficial for tolerating neuropathological age-related changes. Some controversial results are outlined, suggesting explanations for the inconsistency of findings. Although clear evidence from interventional studies is lacking, it seems that multi-domain interventions should be recommended to avoid or delay cognitive decline.

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Education and cognitive reserve in old age

Neurology ◽

10.1212/wnl.0000000000007036 ◽

2019 ◽

Vol 92 (10) ◽

pp. e1041-e1050 ◽

Cited By ~ 33

Author(s):

Robert S. Wilson ◽

Lei Yu ◽

Melissa Lamar ◽

Julie A. Schneider ◽

Patricia A. Boyle ◽

...

Keyword(s):

Cognitive Decline ◽

Old Age ◽

Cognitive Reserve ◽

Cognitive Change ◽

Cognitive Testing ◽

Cognitive Test ◽

Standard Scale ◽

Incident Dementia ◽

Higher Educational Attainment ◽

Rapid Cognitive Decline

ObjectiveTo assess the contribution of education to cognitive reserve.MethodsAnalyses are based on older participants in a longitudinal clinical-pathologic cohort study who had annual cognitive testing (n = 2,899) and subgroups that developed incident dementia (n = 696), died, and underwent a neuropathologic examination from which 10 neurodegenerative and cerebrovascular markers were derived (n = 752), or both (n = 405). Cognitive test scores were converted to a standard scale and averaged to yield composite measures of cognition.ResultsParticipants had a mean of 16.3 years of education (SD = 3.7, range 0–30). In all participants, education was associated with initial level of global cognition but not rate of cognitive change. In those who developed dementia, rate of global cognitive decline accelerated a mean of 1.8 years before the diagnosis, but education was not related to the onset or rate of accelerated decline. In the deceased, rate of global cognitive decline accelerated a mean of 3.4 years before death, but higher educational attainment was related to earlier (not later) onset of accelerated decline and unrelated to rate of acceleration. Higher education was associated with lower likelihood of gross and microscopic cerebral infarcts but not with other neuropathologic markers. Education was not related to global cognitive change not attributable to neuropathologic burden and did not decrease the association of higher neuropathologic burden with more rapid cognitive decline.ConclusionThe results suggest that the contribution of education to cognitive reserve is limited to its association with level of cognitive function before old age.

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Case 6-2012: A 45-Year-Old Man with a History of Alcohol Abuse and Rapid Cognitive Decline

New England Journal of Medicine ◽

10.1056/nejmx120018 ◽

2012 ◽

Vol 366 (14) ◽

pp. 1356-1356

Keyword(s):

Alcohol Abuse ◽

Cognitive Decline ◽

History Of ◽

Rapid Cognitive Decline

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Cognitive reserve in amyotrophic lateral sclerosis (ALS): a population-based longitudinal study

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2020-324992 ◽

2021 ◽

pp. jnnp-2020-324992

Author(s):

Emmet Costello ◽

James Rooney ◽

Marta Pinto-Grau ◽

Tom Burke ◽

Marwa Elamin ◽

...

Keyword(s):

Amyotrophic Lateral Sclerosis ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Cognitive Reserve ◽

Population Based ◽

Protective Role ◽

Drop Out ◽

Longitudinal Change ◽

Activity Data ◽

Lateral Sclerosis

BackgroundAmyotrophic lateral sclerosis (ALS) is often associated with cognitive and/or behavioural impairment. Cognitive reserve (CR) may play a protective role in offsetting cognitive impairment. This study examined the relationship between CR and longitudinal change in cognition in an Irish ALS cohort.MethodsLongitudinal neuropsychological assessment was carried out on 189 patients over 16 months using the Edinburgh cognitive and behavioural ALS screen (ECAS) and an additional battery of neuropsychological tests. CR was measured by combining education, occupation and physical activity data. Joint longitudinal and time-to-event models were fitted to investigate the associations between CR, performance at baseline and decline over time while controlling for non-random drop-out.ResultsCR was a significant predictor of baseline neuropsychological performance, with high CR patients performing better than those with medium or low CR. Better cognitive performance in high CR individuals was maintained longitudinally for ECAS, social cognition, executive functioning and confrontational naming. Patients displayed little cognitive decline over the course of the study, despite controlling for non-random drop-out.ConclusionsThese findings suggest that CR plays a role in the presentation of cognitive impairment at diagnosis but is not protective against cognitive decline. However, further research is needed to examine the interaction between CR and other objective correlates of cognitive impairment in ALS.

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P4-031 Moderate coffee consumption is associated with a less rapid cognitive decline in elderly men. The fine study

Neurobiology of Aging ◽

10.1016/s0197-4580(04)81589-6 ◽

2004 ◽

Vol 25 ◽

pp. S481

Author(s):

Boukje M. van Gelder ◽

Brian Buijsse ◽

Sandra Kalmijn ◽

Marja Tijhuis ◽

Simona Giampaoli ◽

...

Keyword(s):

Cognitive Decline ◽

Coffee Consumption ◽

Elderly Men ◽

Rapid Cognitive Decline

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P2-421: Indicators of Cognitive Reserve Moderate the Adverse Relationship Between Poor Diet Quality and Cognitive Decline in Independent Older Adults: The Nuage Study

Alzheimer s & Dementia ◽

10.1016/j.jalz.2016.06.1633 ◽

2016 ◽

Vol 12 ◽

pp. P806-P806

Author(s):

Matthew D. Parrott ◽

Alexandra J. Fiocco ◽

Pierre-Hugues Carmichael ◽

Nicole D. Anderson ◽

Danielle Laurin ◽

...

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Diet Quality ◽

Cognitive Reserve ◽

Poor Diet

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Depressive Symptoms and Cognitive Decline in Late Life

Archives of General Psychiatry ◽

10.1001/archpsyc.63.2.153 ◽

2006 ◽

Vol 63 (2) ◽

pp. 153 ◽

Cited By ~ 180

Author(s):

Mary Ganguli ◽

Yangchun Du ◽

Hiroko H. Dodge ◽

Graham G. Ratcliff ◽

Chung-Chou H. Chang

Keyword(s):

Depressive Symptoms ◽

Cognitive Decline ◽

Late Life

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Idea Density Measured in Late Life Predicts Subsequent Cognitive Trajectories: Implications for the Measurement of Cognitive Reserve

The Journals of Gerontology Series B ◽

10.1093/geronb/gbr162 ◽

2012 ◽

Vol 67 (6) ◽

pp. 677-686 ◽

Cited By ~ 18

Author(s):

S. T. Farias ◽

V. Chand ◽

L. Bonnici ◽

K. Baynes ◽

D. Harvey ◽

...

Keyword(s):

Cognitive Reserve ◽

Late Life

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Longitudinal associations between late-life depression dimensions and cognitive functioning: a cross-domain latent growth curve analysis

Psychological Medicine ◽

10.1017/s003329171600297x ◽

2016 ◽

Vol 47 (4) ◽

pp. 690-702 ◽

Cited By ~ 20

Author(s):

A. Brailean ◽

M. J. Aartsen ◽

G. Muniz-Terrera ◽

M. Prince ◽

A. M. Prina ◽

...

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Processing Speed ◽

Memory Function ◽

Somatic Symptoms ◽

Late Life ◽

Late Life Depression ◽

Latent Growth ◽

Depressed Affect ◽

Over Time

BackgroundCognitive impairment and depression often co-occur in older adults, but it is not clear whether depression is a risk factor for cognitive decline, a psychological reaction to cognitive decline, or whether changes in depressive symptoms correlate with changes in cognitive performance over time. The co-morbid manifestation of depression and cognitive impairment may reflect either a causal effect or a common cause, depending on the specific symptoms experienced and the cognitive functions affected.MethodThe study sample comprised 1506 community-dwelling older adults aged ⩾65 years from the Longitudinal Aging Study Amsterdam (LASA). We conducted cross-domain latent growth curve analyses to examine longitudinal associations between late-life depression dimensions (i.e. depressed affect, positive affect, and somatic symptoms) and specific domains of cognitive functioning (i.e. processing speed, inductive reasoning, immediate recall, and delayed recall).ResultsPoorer delayed recall performance at baseline predicted a steeper increase in depressed affect over time. Steeper decline in processing speed correlated with a steeper increase in somatic symptoms of depression over time.ConclusionsOur findings suggest a prospective association between memory function and depressed affect, whereby older adults may experience an increase in depressed affect in reaction to poor memory function. Somatic symptoms of depression increased concurrently with declining processing speed, which may reflect common neurodegenerative processes. Our findings do not support the hypothesis that depression symptoms may be a risk factor for cognitive decline in the general population. These findings have potential implications for the treatment of late-life depression and for the prognosis of cognitive outcomes.

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