High lifelong cognitive reserve prolongs disability‐free survival: The role of cognitive function

Abstract

Introduction:The association between cognitive reserve (CR) and survival with independence is unknown. We examined whether lifelong CR accumulation is associated with disability-free survival and explored the extent to which cognitive function mediates this association.Methods: Within the Rush Memory and Aging Project, 1633 dementia-and disabilityfree participants were followed annually for up to 22 years. Lifelong CR including education, early-/mid-/late-life cognitive activities, and late-life social activity was assessed and tertiled.Results: CR score was dose-dependently associated with disability/death (hazard ratio [HR] 0.96, 95% confidence interval [CI] 0.93-0.99). Compared to low CR, the HR (95% CI) of disability/death was 0.82 (0.70-0.95) for high CR. The median disability-free survival time was prolonged by 0.99 (95% CI 0.28-1.71) years for participants with high CR. Cognitive function mediated 35.7% of the association between CR and disabilityfree survival.Discussion: High lifelong CR was associated with prolonged disability-free survival.Cognitive function mediates about one-third of this association. Our findings underscore the importance of CR for healthy aging.

Toward harmonization of strategies for investigating lucidity in AD/ADRD: A preliminary research framework

“…Examples of existing theoretical frameworks that may be salient at that point and may help to inform a theoretical framework for ELs include Cognitive Reserve Theory and the Delirium Systems Integration Theory 45,46 . Both theories attempt to explain the mechanisms by which cognitive function varies across individuals (cognitive reserve) and within individuals (delirium systems integration) over time 45–47 . These other theoretical perspectives, however, are broad in scope and perspective.…”

“… 45 , 46 Both theories attempt to explain the mechanisms by which cognitive function varies across individuals (cognitive reserve) and within individuals (delirium systems integration) over time. 45 , 46 , 47 These other theoretical perspectives, however, are broad in scope and perspective. On the contrary, the proposed preliminary framework is narrowly focused on specifying how lucidity is operationalized.…”

Association of Motor Function With Cognitive Trajectories and Structural Brain Differences

“…All participants provided written informed consent and repository consent to allow sharing of their data. 19…”

“…MRI has been widely applied to examine structural brain changes and can provide insight into the pathophysiology underlying changes in cognition. 14 Previous neuroimaging studies reported an association between motor function and reduced gray matter, white matter, and hippocampal volumes, [15][16][17][18][19] though other studies produced conflicting results. 15,16 So far, few studies have systematically addressed the association between motor function and domain-specific cognitive trajectories and brain structural measures assessed by MRI scans.…”

The indirect effect of cognitive reserve on the relationship between age and cognition in pathological ageing: A cross‐sectional retrospective study in an unselected and consecutively enrolled sample

“…Higher CR reduces the prevalence of dementia, bringing down public costs related to care (Zissimopoulos et al, 2015). At the individual level, this corresponds to fewer years of disability and patient dependence (Li et al, 2022) and yields important practical implications for prevention and cure policies for neurodegenerative diseases (Wu et al, 2016). CR can only be indirectly measured, using socio‐behavioural proxies (Stern et al, 2020), which share an underlying process and each adds a unique contribution to CR (Opdebeeck et al, 2016).…”