Cognitive reserve and Alzheimer disease
1Cognitive Neuroscience Division of the Taub Institute, New York, NY 10032, USA. ys11@columbia.edu
Alzheimer Disease and Associated Disorders
|June 15, 2006
Summary
Higher cognitive reserve, built through education and leisure, may reduce Alzheimer disease (AD) risk. This reserve may involve more efficient brain networks or compensatory mechanisms, potentially delaying AD diagnosis.
Area of Science:
- Neuroscience
- Epidemiology
- Gerontology
Background:
- Epidemiologic studies link higher IQ, education, occupation, and leisure activities to reduced Alzheimer disease (AD) risk.
- Cognitive reserve (CR) proposes that individual differences in cognitive processing provide resilience against brain pathology and aging.
- CR may operate via neural reserve (more efficient networks) or neural compensation (alternate network use).
Purpose of the Study:
- To explore the concept of cognitive reserve (CR) and its potential mechanisms.
- To discuss the role of CR in modulating the clinical expression of Alzheimer disease (AD) pathology.
- To consider CR as a target for interventions to forestall AD diagnosis.
Main Methods:
- Review of epidemiologic evidence linking lifestyle factors to AD risk.
- Conceptualization of neural reserve and neural compensation as CR mechanisms.
- Discussion of neuroimaging findings related to the neural basis of CR.
Main Results:
- Individuals with higher levels of education, occupational attainment, and leisure engagement show a reduced risk of developing AD.
- Neuroimaging studies are beginning to elucidate the neural underpinnings of cognitive reserve.
- Cognitive reserve appears to influence how Alzheimer disease pathology is clinically expressed.
Conclusions:
- Cognitive reserve is a significant factor in understanding individual differences in Alzheimer disease (AD) susceptibility and progression.
- CR may involve both inherent neural efficiency and the recruitment of alternative brain networks.
- Enhancing cognitive reserve presents a potential strategy for delaying or preventing the clinical diagnosis of AD.
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