The conceptualization and measurement of cognitive reserve using common proxy indicators: Testing some tenable reflective and formative models

Ikanga, Jean; Hill, Elizabeth M.; MacDonald, Douglas A.

doi:10.1080/13803395.2016.1201462

Cited by 16 publications

(15 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, dyslexia and other learning difficulties are detrimental to literacy attainment and result in an inaccurate estimate of CR. Hence, some authors suggest that education is the better proxy (e.g., Ikanga et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Cognitive reserve and cognitive performance of patients with focal frontal lesions

et al. 2017

View full text Add to dashboard Cite

The Cognitive reserve (CR) hypothesis was put forward to account for the variability in cognitive performance of patients with similar degrees of brain pathology. Compensatory neural activity within the frontal lobes has often been associated with CR. For the first time we investigated the independent effects of two CR proxies, education and NART IQ, on measures of executive function, fluid intelligence, speed of information processing, verbal short term memory (vSTM), naming, and perception in a sample of 86 patients with focal, unilateral frontal lesions and 142 healthy controls. We fitted multiple linear regression models for each of the cognitive measures and found that only NART IQ predicted executive and naming performance. Neither education nor NART IQ predicted performance on fluid intelligence, processing speed, vSTM or perceptual abilities. Education and NART IQ did not modify the effect of lesion severity on cognitive impairment. We also found that age significantly predicted performance on executive tests and the majority of our other cognitive measures, except vSTM and GNT. Age was the only predictor for fluid intelligence. This latter finding suggests that age plays a role in executive performance over and above the contribution of CR proxies in patients with focal frontal lesions. Overall, our results suggest that the CR proxies do not appear to modify the relationship between cognitive impairment and frontal lesions.

show abstract

Section: Discussionmentioning

confidence: 99%

Cognitive reserve and cognitive performance of patients with focal frontal lesions

et al. 2017

View full text Add to dashboard Cite

show abstract

“…First, various studies used lifestyle proxies to operationalize CR (e.g., education, occupation, or physical activity), 20 but there is no consensus about the validity of these indirect measures. 3,21,22 Second, presence of AD was often established through clinical evaluation without consideration of AD biomarkers, likely resulting in samples confounded with non-AD participants. Third, few studies comprehensively investigated the relationship between CR and clinical progression across the entire AD spectrum, thus hampering a direct comparison between disease stages.…”

mentioning

confidence: 99%

Cognitive reserve and clinical progression in Alzheimer disease

et al. 2019

View full text Add to dashboard Cite

ObjectiveTo investigate the relationship between cognitive reserve (CR) and clinical progression across the Alzheimer disease (AD) spectrum.MethodsWe selected 839 β-amyloid (Aβ)–positive participants with normal cognition (NC, n = 175), mild cognitive impairment (MCI, n = 437), or AD dementia (n = 227) from the Alzheimer's Disease Neuroimaging Initiative (ADNI). CR was quantified using standardized residuals (W scores) from a (covariate-adjusted) linear regression with global cognition (13-item Alzheimer's Disease Assessment Scale–cognitive subscale) as an independent variable of interest, and either gray matter volumes or white matter hyperintensity volume as dependent variables. These W scores, reflecting whether an individual's degree of cerebral damage is lower or higher than clinically expected, were tested as predictors of diagnostic conversion (i.e., NC to MCI/AD dementia, or MCI to AD dementia) and longitudinal changes in memory (ADNI-MEM) and executive functions (ADNI-EF).ResultsThe median follow-up period was 24 months (interquartile range 6–42). Corrected for age, sex, APOE4 status, and baseline cerebral damage, higher gray matter volume-based W scores (i.e., greater CR) were associated with a lower diagnostic conversion risk (hazard ratio [HR] 0.22, p < 0.001) and slower decline in memory (β = 0.48, p < 0.001) and executive function (β = 0.67, p < 0.001). Stratified by disease stage, we found similar results for NC (diagnostic conversion: HR 0.30, p = 0.038; ADNI-MEM: β = 0.52, p = 0.028; ADNI-EF: β = 0.42, p = 0.077) and MCI (diagnostic conversion: HR 0.21, p < 0.001; ADNI-MEM: β = 0.43, p = 0.003; ADNI-EF: β = 0.59, p < 0.001), but opposite findings (i.e., more rapid decline) for AD dementia (ADNI-MEM: β = −0.91, p = 0.002; ADNI-EF: β = −0.77, p = 0.081).ConclusionsAmong Aβ-positive individuals, greater CR related to attenuated clinical progression in predementia stages of AD, but accelerated cognitive decline after the onset of dementia.

show abstract

“…These steps will help determine the true effects of cognitive reserve in moderating impairment associated with increased pathological burden. Other cognitive reserve indicators, including engagement in cognitive, physical, and social activity, have demonstrated additive and independent weighting on the cognitive reserve construct (eg, Ikanga et al 90 ), and should be investigated as markers of cognitive reserve in people with stroke. 66 The use of multi-indicator assessments and the development of novel cognitive reserve measurement methods (eg, Reed et al 91 ) might help reduce the confounding effects of SES-related factors, better address the gap between the conceptualization/operationalization of the construct and provide stronger support for the cognitive reserve mechanism.…”

Section: Limitations Future Directions and Conclusionmentioning

confidence: 99%

Cognitive Reserve as an Emerging Concept in Stroke Recovery

Rosenich

Paquet

Koblar

et al. 2020

Neurorehabil Neural Repair

View full text Add to dashboard Cite

Stroke is a leading cause of death and disability. It is a complex and largely heterogeneous condition. Prognosis for variations in impairment and recovery following stroke continues to be challenging and inaccurate, highlighting the need to examine the influence of other currently unknown variables to better predict and understand interindividual differences in stroke impairment and recovery. The concept of “cognitive reserve,” a feature of brain function said to moderate the relationship between brain pathology and clinical outcomes, might provide a partial explanation. This review discusses the potential significance of cognitive reserve in the context of stroke, with reference to reduced burden of disability poststroke, health promotion, intervention and secondary prevention of cognitive impairment, ease and challenges of translation into clinical practice, prognosis and prediction of recovery, and clinical decisions and trial stratification. Discussions from the review aim to encourage stroke clinicians and researchers to better consider the role of premorbid, lifestyle-related variables, such as cognitive reserve, in facilitating successful neurological outcomes and recovery following stroke.

show abstract

The conceptualization and measurement of cognitive reserve using common proxy indicators: Testing some tenable reflective and formative models

Cited by 16 publications

References 40 publications

Cognitive reserve and cognitive performance of patients with focal frontal lesions

Cognitive reserve and cognitive performance of patients with focal frontal lesions

Cognitive reserve and clinical progression in Alzheimer disease

Cognitive Reserve as an Emerging Concept in Stroke Recovery

Contact Info

Product

Resources

About