Cognitive reserve and executive function: Effect on judgment of health and safety

Abstract

Abstract-Individuals with the same neurological conditions do not necessarily manifest the same behavioral presentation, which suggests differences in resilience and vulnerability among individuals, a concept known as cognitive reserve. This study sought to explore the relationship among cognitive reserve, executive functioning, and health and safety judgment in a sample of older adult inpatients in an extended medical care unit at a Veterans Health Administration hospital. We hypothesized that cognitive reserve, as determined by an estimate of premorbid intellectual ability, would act as a protective factor against poor judgment in older adults with executive dysfunction. Participants included 200 Veterans who completed a comprehensive neuropsychological assessment, including measures of health and safety judgment, executive functioning, global cognitive functioning, and premorbid intellectual ability. After controlling for global cognitive functioning, executive functioning abilities did not have an effect on judgment abilities among those with high estimated intellectual ability. However, executive functioning had a significant effect on judgment abilities among those with low estimated intellectual ability. Our results suggest that intact executive functioning is critical for making appropriate health and safety decisions for patients with lower measured intellectual abilities and provide further support for the cognitive reserve model. Clinical implications are also discussed.

Influence of cognitive reserve on neuropsychological functioning in bipolar disorder: Findings from a 5‐year longitudinal study

“…[16][17][18][19] Because CR cannot be easily quantified, proxy measures such as premorbid intellectual ability, education, occupational attainment, and leisure activity have been used as surrogate variables and are established as standards of CR measurement in the literature. 20 CR has most frequently been adopted in research on acquired or neurodegenerative conditions, such as Alzheimer's disease, traumatic brain injury, and vascular disease; [21][22][23][24][25][26][27][28] however, CR has only recently been applied to neuropsychiatric disorders, such as schizophrenia, post-traumatic stress disorder, and BP, to help explain variability in symptom severity and neuropsychological correlates. 1,29,30 In one of the few studies examining CR in BP, Forcada and colleagues 31 found that BP participants with lower neuropsychological functioning (in verbal and visual memory and executive functioning) also tended to have lower psychosocial functioning, education, occupational attainment, and leisure activities compared to the control group.…”

Effect of digital game intervention on cognitive functions in older adults: a multiple baseline single case experimental design study

“…Interventions related to executive functions, such as the N-back test and judgment task [ 31 , 32 ] did not reveal significant improvements. This might suggest the need for activities that involve three-dimensional (3D) environments or games that require predicting the surrounding space in a more 3D manner and strategizing [ 11 ].…”

Pilot validation of a verbal practical judgement assessment (VPJ) among community-dwelling older adults in Israel: the first step toward a national standard

“…16,31 Judgement, cognition, and functioning We found a correlation between function, cognition, and judgement, which strengthens our conclusion regarding probable convergent validity. Accordingly, in the study of Hinrich and colleagues 32 , on the relationship between judgement and functional status and ability to perform independent daily activities in a population with dementia, there is a significant relationship between the level of cognition and the functional state, as well as between the functional state of the person and judgement ability. The researchers found that functional status and cognition were jointly associated with 56% of the variance in judgement.…”