Psychometric properties of the Italian version of the Cognitive Reserve Scale (I-CRS)

Abstract

The original definition of cognitive reserve (CR) refers to the individual differences in cognitive performance after a brain damage or pathology. Several proxies were proposed to evaluate CR (education, occupational attainment, premorbid IQ, leisure activities). Recently, some scales were developed to measure CR taking into account several cognitively stimulating activities. The aim of this study is to adapt the Cognitive Reserve Scale (I-CRS) for the Italian population and to explore its psychometric properties. I-CRS was administered to 547 healthy participants, ranging from 18 to 89 years old, along with neuropsychological and behavioral scales to evaluate cognitive functioning, depressive symptoms, and apathy. Cronbach's α, corrected item-total correlations, and the inter-item correlation matrix were calculated to evaluate the psychometric properties of the scale. Linear regression analysis was performed to build a correction grid of the I-CRS according to demographic variables. Correlational analyses were performed to explore the relationships between I-CRS and neuropsychological and behavioral scales. We found that age, sex, and education influenced the I-CRS score. Young adults and adults obtained higher I-CRS scores than elderly adults; women and participants with high educational attainment scored higher on I-CRS than men and participants with low education. I-CRS score correlated poorly with cognitive and depression scale scores, but moderately with apathy scale scores. I-CRS showed good psychometric properties and seemed to be a useful tool to assess CR in every adult life stage. Moreover, our findings suggest that apathy rather than depressive symptoms may interfere with the building of CR across the lifespan.

Measuring Cognitive Reserve (CR) – A systematic review of measurement properties of CR questionnaires for the adult population

“…There was inconsistent evidence on the construct validity of the CRS in healthy participants when taking into account that the methodological quality was overall good, but about half of the studies could not find expected significant associations between cognitive outcomes and the CRS. Altieri et al [58] found weak positive associations between CRS scores and global cognitive functioning (MMSE, r = 0.26, p<0.001 and Montreal Cognitive Assessment, r = 0.28, p<0.001), long-term verbal memory (immediate recall Rey Auditory Verbal Learning Test (RAVLT), r = 0.25, p<0.001 and delayed recall RAVLT, r = 0.25, p<0.001) and visuo-spatial constructional abilities (Constructional Apraxia Test, r = 0.19, p<0.001). Cancino et al [59] found an association of the CRS with the Addenbrooke's Cognitive Examination-Revised (β = 0.223, p = 0.005).…”

“…In a further study by León et al [60], a correlation between the CRS and years of education (partial ŋ 2 = 0.07, p = 0.004) was found, but not with premorbid intelligence as measured with a Vocabulary subtest (r = 0.09, p = 0.33), nor occupation (F 2,116 = 0.11, p = 0.898). In the Italian version, Altieri et al [58] found associations between the CRS and years of education and occupation (r = 0.33 and ρ = 0.16, respectively).…”

“…However, Cronbach alphas for the four sub-scales were not provided. Altieri et al [58] reported a Cronbach’s alpha of 0.73 for the total scale. For the different life-stages, alpha values ranged from 0.738 and 0.747.…”

“…Altieri et al [58] provided good evidence of the test-retest reliability of the CRS in a subsample of 15 participants, who were comparable to the whole sample according to demographic characteristics. Scores of the total CRS showed to be reliable over 4-weeks (r = 0.983, p<0.001).…”

“…Cross-cultural validity was moderate for the Greek version of the CRIq [42] and the Portuguese version of the CRQ [53], while it was well performed for the Italian version of the CRS [58]. When adopting a questionnaire for another culture, an integral and precise translation by an expert including forward and backward translation, item revision and a pretest of the translated version in the target population is required [26,67].…”