Moderating effect of cognitive reserve on brain integrity and cognitive performance

Abstract

BackgroundDementia syndrome is one of the most devastating conditions in older adults. As treatments to stop neurodegeneration become available, accurate and timely diagnosis will increase in importance. One issue is that cognitive performance sometimes does not match the corresponding level of neuropathology, affecting diagnostic accuracy. Cognitive reserve (CR), which can preserve cognitive function despite underlying neuropathology, explains at least some variability in cognitive performance. We examined the influence of CR proxies (education and occupational position) on the relationship between hippocampal or total gray matter volume and cognition.MethodsWe used data from the Czech Brain Aging Study. Participants were clinically confirmed to be without dementia (n = 457, including subjective cognitive decline and amnestic mild cognitive impairment) or with dementia syndrome (n = 113).ResultsFor participants without dementia, higher education magnified the associations between (a) hippocampal volume and executive control (b = 0.09, p = 0.033), (b) total gray matter volume and language (b = 0.12, p < 0.001), and (c) total gray matter volume and memory (b = 0.08, p = 0.018). Similarly, higher occupational position magnified the association between total gray matter volume and (a) attention/working memory (b = 0.09, p = 0.009), (b) language (b = 0.13, p = 0.002), and (c) memory (b = 0.10, p = 0.013). For participants with dementia, the associations between hippocampal (b = –0.26, p = 0.024) and total gray matter (b = –0.28, p = 0.024) volume and visuospatial skills decreased in magnitude with higher education.ConclusionWe found that the association between brain volume and cognitive performance varies based on CR, with greater CR related to a stronger link between brain volume and cognition before, and a weaker link after, dementia diagnosis.

Cognitive reserve moderates the relationship between childhood maltreatment, objective and subjective cognition, and psychosocial functioning in individuals with first-episode psychosis.

“…We found that individuals with FEP who reported overall CM and higher CR experienced less subjective cognitive complaints so that the effects of CM on less daily cognitive complaints and difficulties were moderated by CR. The finding that CR moderated the subjective cognitive complaints is consistent with existing literature (Jia et al, 2021; Mazzeo et al, 2019) and in line with the majority of research to date has studied how CR is likely to impact cognitive outcomes (Amoretti et al, 2022; Ayesa-Arriola et al, 2023; Grande et al, 2017; Nelson et al, 2022; Opdebeeck et al, 2018). It seems that CR may enhance mechanisms of information processing, favoring the performance of tasks involving other cognitive constructs in those with subjective cognitive complaints, that is, everyday memory and related cognitive concerns involved in daily mental tasks in people with FEP, as previously suggested (Lojo-Seoane et al, 2018).…”

“…Our exploratory analyses provide insight into understanding the nuances of this relationship. Although CR is studied extensively as a valuable construct to predict cognitive and psychosocial outcomes (Amoretti & Ramos-Quiroga, 2021; Herrero et al, 2020; Nelson et al, 2022), there is a dearth of research regarding whether and how CR interacts with cognitive and psychosocial functioning jointly impacted by CM, especially in individuals when psychosis begins to take shape. Furthermore, without an existing theoretical framework explaining associations between CR and CM, this study investigated whether CR moderates between CM, objective and subjective cognition, and psychosocial functioning in a treatment-seeking outpatient sample of adults with FEP.…”

Preclinical Brain Network Abnormalities in Patients with Subjective Cognitive Decline

“…Some studies reported decreased hippocampal volume in SCD subjects [36,37,38,39,40], while other studies failed in identifying any significant hippocampal atrophy [41,42,43,44,45]. This might be explained by a high heterogeneity of SCD individuals, whose mismatch between regional brain volumetrics and symptoms may be accounted in either direction by other factors, such as cognitive reserve [46].…”

Cognitive resilience/reserve: Myth or reality? A review of definitions and measurement methods

“…A study involving 1347 older adults supported the importance of having an abundant early CR (measured by educational, occupational attainment) and late‐life leisure activity (measured by mental, physical, and social activities) in preventing cognitive impairment 37,38 . In a paper of Nelson et al., higher education and occupational position were used as CR measures 39 . The authors considered higher education as an explanation for the associations between hippocampal volume and performance in executive control, total gray matter volume, and language, as well as memory.…”

“… 37 , 38 In a paper of Nelson et al., higher education and occupational position were used as CR measures. 39 The authors considered higher education as an explanation for the associations between hippocampal volume and performance in executive control, total gray matter volume, and language, as well as memory. Similarly, the authors found that higher occupational position magnified the association between total gray matter volume and attention/working memory, language, and memory.…”