The theory of the multiple reserves: The cognitive, physical, psychological and social factors that determine the quality of aging

Abstract

AbstractBackgroundIn the 1980s the finding that education was linked to lower risk of Alzheimer’s disease (AD) led to the concept of cognitive reserve (CR). Extensive evidence of the protective role of cognitive activities in school, as well as at home and at work has supported the concept of CR. However, AD is clearly a multifactorial condition and there are other important lifestyle factors linked to AD risk.MethodThe literature was searched to find factors other than CR that are protective against the development of AD.ResultThe theory of the multiple reserves presents the physical, psychological and social factors that must be considered. Physical reserve includes the health of all the bodies' systems, including the microbiome. Psychological reserve considers emotional stability and ability to maintain healthy mental functions in response to stress. Social reserve considers interpersonal networks and support systems and the ability to be connected to others and society.ConclusionThe multiple reserve concept helps to demonstrate the opportunities for reducing AD risk through development of the four reserves. Cognitive activities throughout life should be enhanced, and ways to elevate the other reserve factors should be developed, Persons should be encouraged to enhance all of the four reserve factors to reduce their risk of the disease, as well as reduce the rate of progression. Furthermore, public policy should be designed to augment all four of the reserves all each stage of life.