Effect of Cognitive Reserve on the Association of Vascular Brain Injury With Cognition

Abstract

Objective:To determine whether cognitive reserve attenuates the association of vascular brain injury with cognition.Methods:Cross-sectional data were analyzed from two harmonized studies: the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM) and the Prospective Urban and Rural Epidemiology (PURE) study. Markers of cognitive reserve were education, involvement in social activities, marital status, height, and leisure physical activity, which were combined into a composite score. Vascular brain injury was defined asnon-lacunar brain infarcts or high white matter hyperintensity (WMH) burden on MRI. Cognition was assessed using the Montreal Cognitive Assessment Tool (MoCA) and the Digit Symbol Substitution Test (DSST).Results:There were 10,450 participants age 35-81. Mean age was 58.8 years (range 35 to 81) and 55.8% were female. Education, moderate leisure physical activity, being in a marital partnership, being taller, and participating in social groups were each independently associated with higher cognition, as was the composite cognitive reserve score. Vascular brain injury was associated with lower cognition (beta-0.35 [95% CI -0.53 to -0.17] for MoCA and beta -2.19 [95% CI-3.22 to -1.15] for DSST)-but the association was not modified by the composite cognitive reserve variable (interaction p=0.59 for MoCA and p=0.72 for DSST).Conclusions:Both vascular brain injury and markers of cognitive reserve are associated with cognition. However, the effects were independent such that the adverse effects of covert vascular brain injury were not attenuated by higher cognitive reserve. To improve cognitive brain health, interventions to both prevent cerebrovascular disease and promote positive lifestyles are needed.

Effects of cognitive reserve proxies on cognitive function and frontoparietal control network in subjects with white matter hyperintensities: A cross‐sectional functional magnetic resonance imaging study

“…Cognitive reserve is a theoretical concept that explains the individual differences in maintaining cognitive function in the face of brain pathology. First, greater CR appears to be associated with better cognitive performance in WMH subjects 6,8,9 . Second, CR may act as a moderator between the burden of WMH and cognitive performance.…”

“…First, greater CR appears to be associated with better cognitive performance in WMH subjects. 6,8,9 Second, CR may act as a moderator between the burden of WMH and cognitive performance. A more significant burden of WMH links to poorer cognitive performance in subjects with low CR.…”

Cognitive decline is associated with frequency-specific resting state functional changes in normal aging

“…Third, the elderly individuals included in the present study all had a relatively high level of education. Previous evidences indicated that high education was one of strongest marker of cognitive reserve which may shape cognitive aging trajectories (Durrani et al, 2021;Farfel et al, 2013;Singh-Manoux et al, 2011). Therefore, future studies would be pro t from a larger adult sample with wide levels of education.…”

Disentangling the Relationship Between Chronic Kidney Disease and Cognitive Disorders

“…Thus, low educational attainment is another potential confounder in the association between CKD and cognitive disorders with some evidence of synergy as subtle GFR decline is associated with more rapid cognitive decline in those with lower educational levels (54). However, more recent data in the general population suggests that higher cognitive reserve may not diminish the adverse effects of covert vascular brain injury (55).…”