Cognitive Reserve in Dementia: Implications for Cognitive Training

Abstract

Cognitive reserve (CR) is a potential mechanism to cope with brain damage. The aim of this study was to evaluate the effect of CR on a cognitive training (CT) in a group of patients with dementia. Eighty six participants with mild to moderate dementia were identified by their level of CR quantified by the CR Index questionnaire (CRIq) and underwent a cycle of CT. A global measure of cognition mini mental state examination (MMSE) was obtained before (T0) and after (T1) the training. Multiple linear regression analyses highlighted CR as a significant factor able to predict changes in cognitive performance after the CT. In particular, patients with lower CR benefited from a CT program more than those with high CR. These data show that CR can modulate the outcome of a CT program and that it should be considered as a predictive factor of neuropsychological rehabilitation training efficacy in people with dementia.

Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia

“…Woods et al 2012;van Nes, 2013;Genoe & Dupuis, 2014;Hill et al 2017;Mondini et al 2016;Spector et al, 2017 Individual activities Individual activities as a source to gain strength and to nurture social relationships.…”

Factors Explaining Language Performance After Training in Elders With and Without Subjective Cognitive Decline

“…Finally, with regards to the Stroop test, we used the Interference index proposed by Chafetz and Matthews (2004) . In order to test the role of different predictors regarding CT outcomes in the language domain we have followed a procedure described in Mondini et al (2016) . The measures employed in the analyses resulted from subtracting the baseline scores to the endpoint scores in each of the selected dependent variables.…”

“…For example, lifestyle factors, occupation attainment or education (cognitive reserve proxies) influence individuals’ cognition along life ( Stern, 2012 ). In this vein, Mondini et al (2016) have shown that cognitive reserve (CR) can modulate the general cognitive status (measured by Mini-Mental State Examination; MMSE onward) after a CT program and should be considered as a predictor of CT efficacy in older adults with mild to moderate dementia. In Spain a recently published study ( Lojo-Seoane et al, 2018 ) have shown the influence of CR on episodic memory, WM, and general cognitive performance in adults with subjective cognitive complaints evaluated at baseline and at a follow-up after an interval of about 18 months.…”

The Role of Cognitive Reserve in Alzheimer’s Disease and Aging: A Multi-Modal Imaging Review

“…Corroborating data come from postmortem brain analyses, reporting individuals with high amounts of both A␤ and neurofibrillary tangles who failed to show overt behavioral changes during life [80]; 2) CR can be assumed to exert both global and regional-specific effects in terms of neural reserve and neural compensation. Those underlying substrates vary depending on the pathology and interact with both gray and white matter such as that, in the healthy controls, differences between individuals with high and low CR can be observed along those regions that are generally most affected with normal aging, whereas the same difference will be noticeable in the MCI/AD patients mostly along those regions involved in the pathological degeneration; 3) Despite high CR acting in ensuring better cognitive performances in the face of the same underlying degree of pathology, once diagnosed, those same patients tend to progress faster and to benefit less from interventional therapies (as evidenced by few studies comparing the cognitive benefits of AD patients with high or low CR following extensive cognitive and motor trainings [24,25]).…”

“…Within the aging population, the role of CR becomes even more important when considered in the clinical frame, given that several studies have reported CR as involved in exerting a protective role in the face of neurodegenerative pathologies [13][14][15], delaying their clinical worsening [3,16], and in ensuring better cognitive performances [17]. However, once clinically reaching the time of AD diagnosis, individuals with higher CR have also been reported to progress faster within the disease [18][19][20][21][22][23] and to benefit less from interventional therapies [24,25]. On the other hand, within the healthy population, CR has been generally associated with longer rates of survival [11] and an overall better quality of life [26].…”