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Cerebral small vessel disease, cognitive reserve and cognitive dysfunction.

Daniela Pinter1, Christian Enzinger1,2, Franz Fazekas3

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Higher cognitive reserve, like education, can buffer against the negative effects of cerebral small vessel disease (CSVD) on cognitive function. This suggests cognitive reserve may mitigate age-related brain changes and functional decline.

Keywords:
Aging of the brainCerebral small vessel disease (CSVD)Cognitive reserveSuccessful agingWMHWhite matter changes

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Area of Science:

  • Neurology
  • Neuroscience
  • Gerontology

Background:

  • Cognitive reserve explains individual differences in compensating for age-related brain changes through intellectual enrichment.
  • Cerebral small vessel disease (CSVD) is a prevalent age-related brain vascular condition causing tissue damage, functional loss, disability, and cognitive decline in older adults.

Purpose of the Study:

  • To review existing research on cognitive reserve in relation to CSVD.
  • To explore the potential of promoting cognitive reserve to moderate the impact of CSVD on cognitive function and functional outcomes.
  • To identify gaps and propose future research directions.

Main Methods:

  • Systematic review of studies investigating cognitive reserve and CSVD.
  • Searches conducted in PubMed and MEDLINE electronic databases.
  • Analysis of six studies (7893 subjects) focusing on white matter hyperintensities (WMH) and one study (247 patients) on CADASIL.

Main Results:

  • Existing studies generally confirm that higher cognitive reserve, particularly educational attainment, attenuates the negative impact of white matter hyperintensities (WMH) on cognitive function.
  • The reviewed studies predominantly focused on a single feature of CSVD (WMH).

Conclusions:

  • Cognitive reserve, specifically educational attainment, appears to protect against the cognitive consequences of white matter hyperintensities in CSVD.
  • Further research is needed to examine this association across all CSVD features and other functional losses like gait.
  • Future intervention studies are required to determine methods for increasing cognitive reserve and its protective effects.