Association of cognitive reserve with cognitive function and quality of life in the years following a diagnosis of dementia: initial findings from the IDEAL study

Abstract

AbstractBackgroundEffects of brain pathology or ageing on cognitive function are moderated by an individual’s ability to optimise or maximise the use of the brain’s resources to perform tasks, and is a concept known as cognitive reserve. In dementia, cognitive reserve may reflect the capacity to provide a buffer against effects of dementia‐related brain pathology, resulting in a delay in signs and symptoms of dementia. Studies have found that a higher level of education may not only lead to a delay in the onset of dementia, but impact on the rate of cognitive decline following a diagnosis. Here we investigate whether a latent measure of cognitive reserve at diagnosis impacts on cognitive function or quality of life in the years following a diagnosis.MethodWe used longitudinal data from 1545 individuals with mild‐to‐moderate dementia participating in the IDEAL study. Assessments took place on entry, and at 12 and 24 months. A latent measure of cognitive reserve was created based on education, social class and engagement in social and cognitive activities. Latent growth curve models were used to look for associations of cognitive reserve at diagnosis with cognitive function and quality of life in the years following diagnosis.ResultA higher cognitive reserve was associated with higher cognitive function at the time of diagnosis, but following diagnosis individuals with a higher cognitive reserve had a faster rate of decline in cognitive function. Whilst higher cognitive reserve was associated with a higher quality of life at the time of diagnosis, there was no association between cognitive reserve and change in quality of life in the years following diagnosis.ConclusionThose with a higher cognitive reserve at baseline are more likely to decline in cognitive function at a greater rate following diagnosis suggesting that it may be possible to identify individuals who may decline more quickly based on their education, social class and social and cognitive activities later in life.