cognitive reserve

Question 1

what is the cognitive reserve

Answer 1

a buffer or resilience to AD

Question 2

features of the cog reserve

Answer 2

-concept or abstract idea
-stern 2002: not always an obvious relationship between brain damage and test performance
-stern 2009: people sustain different levels of damage before the effects are observed
(suggest a buffer against damage)

Question 3

why does cog reserve potentially hide evidence of AD for some time

Answer 3

indivs use alternative methods to maintain function e.g compensatory approaches

Question 4

what is the brain reserve

Answer 4

-larger brains and more neurons can sustain more damage
-they have greater potential to be resilient and function adequately for longer

Question 5

what is the threshold model of brain reserve

Answer 5

satz 1993
-disorder/injury/ age related decline has to exceed brain reserve threshold to have visible effect
-only brain reserve can determine the observable outcome
-similar types of damage doesnt have the same effect

Question 6

weakness of threshold model

Answer 6

-cannot account for other indiv diff and doesnt take compensatory processing into account
-very narrow approach

Question 7

does cog reserve have a fixed threshold

Answer 7

no

Question 8

can the levels of cog reserve be enhanced

Answer 8

yes

Question 9

what makes people more resilient to damage

Answer 9

-indivs who have flexibility in neuronal responses
-2 people may have the same amount of brain reserve but the person with more cog reserve is likely to tolerate greater damage

Question 10

is cognitive reserve active or passive

Answer 10

active
-dependent on choices throughout development
-can be increased
-indiv differences and lifestyle factors can define age related brain change and resilience to pathology

Question 11

is brain reserve active or passive

Answer 11

passive
-dependent on brain size and neuron count
-we cannot directly control
-indiv diff in brain structure defines age related brain change and resilience to pathology

Question 12

could brain reserve and cog reserve be interlinked

Answer 12

yes

Question 13

experience induced neuroplasticity research

Answer 13

kempermann et al 2002
-animal models suggest there is experienced based neurogenesis
-taught mice a new skill
-after 7 days, they had more neurons
-after 10 days, area of motor cortex increased in size
-over time a new skill leads to tangible changes in the brain

may 2011: support for this research bc cog stimulating activity can compensate for damage

Question 14

experience induced neuroplasticity human research

Answer 14

draganski et al 2004
-juggling intervention
-daily training for 3 months
-structural change: increased grey matter at junction between temporal and occipital lobe
-humans can also influence their neuroplasticity

Question 15

what does the neural reserve suggest

Answer 15

-there is not such a division between brain and cognitive reserve as first thought
-differences in cog reserve must have a physiological basis

Question 16

what is the neural reserve

Answer 16

extent of our ability to allocate neural resources and form new processing strategies to keep functioning in the face of damage

Question 17

what factors influence cog reserve

Answer 17

modifiable health factors e.g diet and exercise
education
social support
positive affect
stimulating activities
cognitive training
knowing second lang

Question 18

which factor has the greatest influence on cog reserve

Answer 18

education
-higher education = greater CR
-cog in later life best predicted by educational attainment

Question 19

what other factors is education related to

Answer 19

-markers of brain reserve (larger brains, thicker cortex - Lui et al 2012)
-quality of education more important than years of schooling

Question 20

how does knowing a second lang influence CR

Answer 20

-life long bilingualism leads to more efficient and strengthened connections of neural resources
-can reduce cog decline in AD

Question 21

what are the other contributing factors of bilingualism and CR

Answer 21

age of onset of second lang
proficiency and frequency of lang use

Question 22

exercise and CR

Answer 22

-improves vascular physiology
-can form barrier to cog decline in the face of damage (Barnes 2015)
-increases cerebral blood flow and cerebrovascular reserve to promote greater neurogenesis

Question 23

social activity and CR

Answer 23

-modifies relationship between AD pathology and cog
-less impact of pathology in those with larger social networks (Crowe et al 2003)
-past and present activities count

Question 24

CR and AD

Answer 24

-differences in CR can account for findings related to AD
-mismatch between pathology and test scores
-indivs may have high load in relation to AD brain pathology (plaques and tangles) but not demonstrate deficits in neuropsych tests
-levels of CR prevents symptoms from emerging until the late stages

Question 25

the nun study

Answer 25

Iacono et al 2009
-assessed nuns level of literacy (idea density) by autobiographies written by nuns aged 22 when entering convent
-higher literacy meant lack of cog deficits in AD pathology
-evidence that neurons can be influenced by life experiences

Question 26

CR and AD diagnosis

Answer 26

-indivs with greatest cog reserve will have more advanced pathology at the onset of observable cog decline (at diagnosis)
-these indivs have less time until they reach the point when pathology overwhelms function and they have rapid rate of decline
-CR helps to attenuate experience of AD but this can be a hinderance bc an indiv will not make use of early stage interventions

Question 27

education and diagnosing AD

Answer 27

-indivs with high educational attainment can be misdiagnosed with AD bc of their CR

Question 28

CR and help seeking

Answer 28

Qian et al 2014
-indivs with high SES come to memory clinics at earlier stages of AD

Question 29

limitations of CR

Answer 29

-more details needed on physiological processes that support CR
-need more longitudinal research
-the label of CR may not be useful, may be better to simply refer to lifestyle factors

Question 30

future directions

Answer 30

-implement strategies to maximise CR in those most at risk
-increase education of CR and lifestyle factors across lifespan
-develop person centred training protocols for specific needs e.g exercise vs education
-cog screening of people with low education or poor reading could help detect early cog change/dementia