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

Alzheimers Dement. 2024 May;20(5):3567-3586. doi: 10.1002/alz.13744. Epub 2024 Mar 13.

Abstract

Introduction: This review examines the concept of cognitive reserve (CR) in relation to brain aging, particularly in the context of dementia and its early stages. CR refers to an individual's ability to maintain or regain cognitive function despite brain aging, damage, or disease. Various factors, including education, occupation complexity, leisure activities, and genetics are believed to influence CR.

Methods: We revised the literature in the context of CR. A total of 842 articles were identified, then we rigorously assessed the relevance of articles based on titles and abstracts, employing a systematic approach to eliminate studies that did not align with our research objectives.

Results: We evaluate-also in a critical way-the methods commonly used to define and measure CR, including sociobehavioral proxies, neuroimaging, and electrophysiological and genetic measures. The challenges and limitations of these measures are discussed, emphasizing the need for more targeted research to improve the understanding, definition, and measurement of CR.

Conclusions: The review underscores the significance of comprehending CR in the context of both normal and pathological brain aging and emphasizes the importance of further research to identify and enhance this protective factor for cognitive preservation in both healthy and neurologically impaired older individuals.

Highlights: This review examines the concept of cognitive reserve in brain aging, in the context of dementia and its early stages. We have evaluated the methods commonly used to define and measure cognitive reserve. Sociobehavioral proxies, neuroimaging, and electrophysiological and genetic measures are discussed. The review emphasizes the importance of further research to identify and enhance this protective factor for cognitive preservation.

Keywords: EEG; brain networks; brain reserve; cognitive reserve; cognitive resilience; fMRI; neural reserve.

Publication types

  • Review

MeSH terms

  • Aging / physiology
  • Brain / physiology
  • Cognitive Reserve* / physiology
  • Dementia
  • Humans
  • Neuroimaging