Abstract
IntroductionIn a geographically diverse sample of women, we asked whether cognitive reserve (CR) is best viewed as a general or cognitive domain-specific construct and whether some cognitive reserve domains but not others exert protective effects on risk of developing mild cognitive impairment (MCI) or dementia. MethodsEstimates of general and domain-specific CR were derived via variance decomposition in 972 cognitively intact women from the Women's Health Initiative Study of Cognitive Aging and Women's Health Memory Study Magnetic Resonance Imaging. Women were then followed up for 13 years. ResultsGeneral CR was the strongest predictor of reduced risk for both MCI and dementia, compared to domain-specific CR measures. Verbal memory, figural memory, and spatial CR were independently protective of MCI, but only verbal memory was independently associated with reduced risk for dementia. DiscussionCognitive reserve is a heterogenous construct with valid quantitative measures identifiable across different neuropsychological processes associated with MCI and dementia.
Highlights
Despite the well-established association between neuropathological processes and cognitive aging [1], discrepancies between detected neuropathology and clinical manifestation are common [2]
Our study demonstrated that domain-specific reserve constructs were identifiable with moderate correlations among Cognitive reserve (CR) measures in attention, verbal memory, figural memory, language, and spatial abilities
CR estimates for verbal memory, figural memory, and spatial abilities showed independent protective effects for mild cognitive impairment (MCI), but only verbal memory reserve was associated with reduced risk for dementia
Summary
Despite the well-established association between neuropathological processes and cognitive aging [1], discrepancies between detected neuropathology and clinical manifestation are common [2]. A.J. Petkus et al / Alzheimer’s & Dementia: Translational Research & Clinical Interventions 5 (2019) 118-128 neuropsychological construct representing a dynamic process influenced by an individual’s combined life experience, purportedly explains some of these observed discrepancies [3]. Researchers have typically estimated CR using imprecise sociobehavioral proxy measures [3] (e.g., educational and occupational attainment, vocabulary tests), that are static, and qualitatively vary in populations from different geographical regions [5] and across cohorts
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