What do individual reserves tell us about vulnerable ageing?

Andreas Ihle,Matthias Kliegel

doi:10.1016/s2666-7568(21)00055-6

Abstract

The increase in cognitive impairments and physical health constraints observed with our rising life expectancy constitutes one of the biggest challenges for public health in this century.1 With respect to cognitive health, individuals with greater cognitive and brain reserves have been proposed to be able to maintain cognitive functioning above a clinical threshold for a longer time, although pathology is advancing.2,3 The role of these mechanisms at the later stages of life is not yet clear. Addressing this important question in a prospective cohort study, Jendé Zijlmans and colleagues4 found that greater cognitive and brain reserves were associated with a lower risk of mortality.

Highlights

The increase in cognitive impairments and physical health constraints observed with our rising life expectancy constitutes one of the biggest challenges for public health in this century.[1]
The role of these mechanisms at the later stages of life is not yet clear. Addressing this important question in a prospective cohort study, Jendé Zijlmans and colleagues[4] found that greater cognitive and brain reserves were associated with a lower risk of mortality. They identified a significant interaction of frailty with cognitive reserve, suggesting that greater cognitive reserve is associated with lower mortality in frail participants
Individuals with greater cognitive reserve might be able to maintain cognitive functioning if they still show relatively little functional impairment, because they might still have good overall health, with a cognitive system that is still able to compensate for the ongoing pathology

Summary

Introduction

The increase in cognitive impairments and physical health constraints observed with our rising life expectancy constitutes one of the biggest challenges for public health in this century.[1]. Zijlmans and colleagues highlighted the need to consider the interplay of cognitive reserve and frailty, rather than treating them as independent issues, in order to extend healthy life-years.

Results

Conclusion