Unraveling the Protective Effects of Cognitive Reserve on Cognition and Brain: A Cross-Sectional Study

Dorota Szcześniak; Marta Lenart-Bugla; Błażej Misiak; Anna Zimny; Marek Sąsiadek; Katarzyna Połtyn-Zaradna; Katarzyna Zatońska; Tomasz Zatoński; Andrzej Szuba; Eric E Smith; Salim Yusuf; Joanna Rymaszewska

doi:10.3390/ijerph191912228

Unraveling the Protective Effects of Cognitive Reserve on Cognition and Brain: A Cross-Sectional Study

Int J Environ Res Public Health. 2022 Sep 27;19(19):12228. doi: 10.3390/ijerph191912228.

Affiliations

¹ Department of Psychiatry, Wroclaw Medical University, Pasteura 10, 50-367 Wroclaw, Poland.
² Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
³ Department of Social Medicine, Wroclaw Medical University, Bujwida 44, 50-345 Wroclaw, Poland.
⁴ Department and Clinic of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
⁵ Department of Angiology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
⁶ Department of Clinical Sciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada.
⁷ Population Health Research Institute and Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON L8L 2X2, Canada.

Abstract

This study aimed to investigate the hypothesis that brain maintenance expressed in white matter hyperintensities and brain reserves, defined as gray and white matter volumes, mediate the association between cognitive reserve (CR) and cognitive performance. A cross-sectional population-based observational study was conducted, and the final study sample consisted of 763 participants (282 men and 481 women) with a mean age of 61.11 years (±9.0). Data from different categories were collected from study participants, such as demographic, lifestyle, medical, and psycho-social characteristics. All participants underwent a detailed psychometric evaluation (MoCA and DSST) followed by a brain MRI. Volumetric measurements of the total gray matter (GMvol), total white matter (WMvol), and white matter hyperintensities (WMHvol) were performed using the Computational Anatomy Toolbox 12 (CAT12) and Statistical Parametric Maps 12 (SPM12) based on 3D T1-weighted sequence. Significant direct and indirect effects of cognitive reserve on cognitive functioning were measured with both scales-the MoCA and DSST. In each mediation model, the volumes of WMH and GM were significant mediators for the association between cognitive reserve and cognitive performance. This study confirms the importance of strengthening the cognitive reserve in the course of life through potentially modifiable effects on both cognition and the brain.

Keywords: brain reserve; cognitive functions; white matter hyperintensities.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Brain / diagnostic imaging
Cognition
Cognitive Dysfunction*
Cognitive Reserve*
Cross-Sectional Studies
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
White Matter* / diagnostic imaging

Grants and funding

This work was supported by the National Science Centre grant (NCN no. 2015/17/B/NZ7/02963). The PURE-Poland project is a part of the global PURE study funded by the Population Health Research Institute, the Canadian Institutes of Health Research, and Heart and Stroke Foundation of Ontario and through unrestricted grants from several pharmaceutical companies; the Poland sub-study was partially funded by Polish Ministry of Science and Higher Education grant no. 290/W-PURE/2008/0.