Cognitive Reserve Factors in a Developing Country: Education and Occupational Attainment Lower the Risk of Dementia in a Sample of Lebanese Older Adults

Abstract

Background: Dementia secondary to neurodegenerative diseases is prevalent among older adults and leads to social, psychological and economic burden on patients, caregivers and the community as a whole. Cognitive reserve factors such as education, and mental stimulation among others were hypothesized to contribute to the resilience against age-related cognitive impairment. Educational attainment, occupation complexity, physical activity, and leisure activity are explored in the context of protecting the older adults' cognitive function. We investigated the cognitive reserve effect on dementia, cognitive decline and impairment, and global cognitive function.Methods: This study is a secondary analysis of data from a cross-sectional, community-based cohort study that aimed at investigating factors associated with dementia and their prevalence. The sample was of 508 community based older adults in Lebanon, aged 65 years and above in addition to 502 informants designated by these older adults. Older adults and informants answered structured questionnaires administered by interviewers, as well as a physical assessment and a neurological examination. Older adults were diagnosed for dementia. Global cognitive function, depression, and cognitive decline were assessed.Results: Older adults with dementia had lower levels of education, and attained lower occupational complexity. Factors such as high education, complex occupation attainment, and leisure activity, significantly predicted better global cognitive function. An older adult who attained high education levels or high complexity level occupation was 7.1 or 4.6 times more likely to have better global cognitive function than another who attained lower education or complexity level occupation respectively.Conclusion: These results suggest that cognitive reserve factors ought to be taken into consideration clinically during the course of dementia diagnosis and when initiating community-based preventive strategies.

Active bilingualism delays the onset of mild cognitive impairment

“…In spite of this, whether or not bilingualism confers any benefit in age-related disorders remains a hotly debated topic. On the one hand, the linguistic profile of a bilingual, i.e language proficiency (Bialystok & Feng, 2009;Xie, 2018) and usage (de Bruin, 2020), as well as other cognitive reserve factors, i.e.-social activity (Evans et al, 2018;Scarmeas & Stern, 2003) and occupation (Darwish, Farran, Assaad, & Chaaya, 2018), might act to highlight or, conversely, mask such a bilingual advantage. On the other hand, the incomplete understanding of what drives the effect (if any) (Bak, 2016) makes it more difficult to define the outcome measures and thus increases the probability of false conclusions.…”

Mediatory effect of depression in the relations between cognitive reserve and cognitive abilities. Does a CR index matter?

“…To determine the role of CR in shaping cognitive capacities of people at later stages of life it is necessary to develop more objective CR indicators that minimise the effects of mood. Comprehensive questionnaires, matching the specific nature of the subjects' cultural environment (Darwish, Farran, Assaad, & Chaaya, 2018), will facilitate acquisition of such evidence. conclusions 1.…”

Time for a Systems Biological Approach to Cognitive Aging?—A Critical Review

“…Collectively, the theories discussed in this review have been influential in the cognitive aging literature, and have emphasized the importance of considering factors including sensory abilities in all aged populations when assessing cognitive performance, and the effect of motor speed on cognitive processing speed when utilizing paper-pencil measures of cognition. Some of these theories have also highlighted the impact of individual factors including level of education, occupational attainment (Darwish et al, 2018), dietary patterns (Bowman and Scarmeas, 2019) and physical activity levels, which may play a role in cognitive reserve (Stern, 2002). Despite this, much of the neuropsychological literature does not account for such factors, nor does it assess perceptual ability beyond the basic level of acuity (Füllgrabe et al, 2015;Roberts and Allen, 2016), and the most common measures of cognitive processing speed are still reliant on motor speed (see Ebaid et al, 2017).…”

“…Indeed, several studies have supported the notion that greater educational attainment can slow the trajectory of age-related cognitive decline and can promote the capacity to process tasks more efficiently (Bennett et al, 2003;Cabeza et al, 2016). Additional factors contributing to cognitive reserve are also reported to include complex occupation attainment (i.e., professional occupations or managerial positions), physical and leisure activity (Darwish et al, 2018), as well as dietary patterns (Bowman and Scarmeas, 2019). Though this theory has been influential in providing a framework for intact cognitive function in the face of pathology, the body of research is based on proxy measures of ''cognitive reserve'' which vary from study to study.…”