Cognitive reserve: Concept, determinants, and promotion

Abstract

Maintenance of cognitive function in old age has become increasingly desirable to a human society with an aging population. Various studies have shown that there is major variation in the clinical manifestations and severity of cognitive aging as a result of neurodegenerative changes that are similar in nature and extent. These mismatches led to the emergence of the concept of cognitive reserve (CR), which focuses on the adaptability and the flexible strategies of the brain that allow some people to cope better than others in the circumstance of age-related or Alzheimer's disease (AD)-related pathology. It is believed that CR is mainly influenced by an individual's education, intellect, mental stimulation, participation in leisure activities, dietary preferences, and social stimulation. These determinants of CR help in slowing the rate of memory decline in the normal aging process and also reduce the risk of developing AD. The role of functional neuroimaging has recently gained importance in the context of understanding the neural basis of CR and its relationship to aging-related behavior changes. Future research in this field may enable earlier detection and thus reduction in the prevalence of age-related cognitive changes and AD. This article is a review of the neurobiology of CR, the concept of CR, and the promotion of preserving CR by analyzing its determinants along with their implementation against its deterioration toward cognitive loss and disorders.