Cognitive Reserve

Question 1

What is Cognitive Reserve

Answer 1

• individuals use alternative methods to maintain function
• lack of fixed thresholds
• levels of cognitive reserve can be enhanced so you can actively seek to combat damage
• 2 people may have the same brain reserve but person with more cognitive reserve can tolerate greater damage

Question 2

Brain reserve

Answer 2

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

Question 3

Brain reserve - Threshold for damage
Threshold model (Satz 1993)

Answer 3

• a disorder or injury has to exceed the brain reserve threshold to have a visible effect
• only brain reserve can determine the outcome
• conceptualizes brain reserve as very narrow and rigid approach

Question 4

cognitive reserve (active)

Answer 4

• dependent on choices made throughout development
• can be increased
• individual differences in modifiable lifestyle factors define age-related brain change

Question 5

brain reserve (passive)

Answer 5

• dependent on brain size and neuron count, which we can’t directly control
• maximum limit imposed
• individual differences in brain structure define age-related brain change

Question 6

experience - induced neuroplasticity

Answer 6

• two approaches are not mutually exclusive
• evidence for the impact of the environment on the brain
• animal models suggest there is experienced-induced neurogensis

Question 7

neural reserve

Answer 7

• evidence that there is not such a division between brain reserve and cognitive reserve at first thought
• differences in cognitive processing must have a physiological basis

Question 8

what influences Cognitive reserve?

Answer 8

• variation in CR likely due to lifestyle factors, which provide resilience to damage
• education
• literacy
• bilingualism
• socioeconomic status
• exercise

Question 9

education

Answer 9

• high education = high CR
• cognition in later life is best predicted by educational attainment
• education delays observable signs of pathology

Question 10

literacy/intelligence

Answer 10

• national adult reading test
• better NART = higher CR
• reading ability can protect older adults from cognitive impairment

Question 11

bilingualism

Answer 11

• leads to ore efficient use of neural resources
• which attenuates cognitive decline in AD

Question 12

socioeconomic status

Answer 12

• lower on the scale = more susceptible to behavioral effects of brain damage
• likely to related to the impact it has on education opportunities

Question 13

exercise

Answer 13

• improved vascular physiology forms a barrier to cognitive decline
• exercise increases resting cerebral blood flow

Question 14

review of lifestyle factors

Answer 14

greater cognitive activity may protect against cognitive decline through the repetition of specific skills

Question 15

CR and AD

Answer 15

• differences in CR can account for findings to AD
• their level of CR prevents symptoms from emerging until later stages

Question 16

the ‘nun study’ (Lacono 2009)

Answer 16

• heterogeneity in response to AD lesions in the human brain
• dependent on idea density
• high idea density meant lack of cognitive deficit with AD pathology

Question 17

in relation to diagnosis

Answer 17

individuals with greatest CR will have more advanced pathology at the onset of diagnosis

Question 18

education - diagnosing AD

Answer 18

• individuals with high education can be misdiagnosed as not having AD due to their CR
• education modifies the relationship between AD and cognitive performance
• higher education level may inhibit change from MCI

Question 19

CR - limitations

Answer 19

further detail are needed on the physiological processes that support CR

Question 20

CR - further directions

Answer 20

• implementing strategies for maximizing CR in those most at risk of age-related decline
• increase education across the lifespan