Cognitive Reserve Index Questionnaire Research Articles

Exploring cognitive reserve’s influence: unveiling the dynamics of digital telerehabilitation in Parkinson’s Disease Resilience

Telerehabilitation is emerging as a promising digital method for delivering rehabilitation to Parkinson’s Disease (PD) patients, especially in the early stages to promote brain resilience. This study explores how cognitive reserve (CR), the brain’s ability to withstand aging and disease, impacts the effectiveness of telerehabilitation. It specifically examines the influence of lifelong cognitive activities on the relationship between neural reserve and improved functional abilities following rehabilitation. In the study, 42 PD patients underwent a 4-month neuromotor telerehabilitation program. CR proxies were assessed using the Cognitive Reserve Index questionnaire (CRIq), brain changes via 3T-MRI, and functional response through changes in the 6-Minute Walk Distance (6MWD). Participants were divided into responders (n = 23) and non-responders (n = 19) based on their 6MWD improvement. A multiple regression model was run to test significant predictors of 6MWD after treatment in each group. The results revealed a significant correlation between 6MWD and CRIq scores, but only among responders. Notably, the CRIq Leisure-Time sub-index, along with baseline 6MWD, were predictors of post-treatment 6MWD. These findings highlight CR’s role in enhancing the benefits of telerehabilitation on PD patients’ neuromotor functions. Clinically, these results suggest that neurologists and clinicians should consider patients’ lifestyles and cognitive engagement as important factors in predicting and enhancing the outcomes of telerehabilitation. The study underscores the potential of CR as both a predictor and booster of telerehabilitation’s effects, advocating for a personalized approach to PD treatment that takes into account individual CR levels.

Sleep-wake behavior, perceived fatigability, and cognitive reserve in older adults.

The effects of sleep-wake behavior on perceived fatigability and cognitive abilities when performing daily activities have not been investigated across levels of cognitive reserve (CR). CR Index Questionnaire (CRIq) data were collected and subjected to moderated mediation analysis. In amnestic mild cognitive impairment (aMCI; n=41), CR moderated sleep-related impairments (SRIs), and fatigability at low CR (CRIq<105.8, p=0.004) and mean CR (CRIq=126.9, p=0.03) but not high CR (CRIq>145.9, p=0.65) levels. SRI affected cognitive abilities mediated by fatigability at low CR (p<0.001) and mean CR (p=0.003) levels. In healthy controls (n=13), SRI in fatigability did not alter cognitive abilities across CR levels; controls had higher leisure scores than patients with aMCI (p=0.003, effect size=0.93). SRI can amplify impaired cognitive abilities through exacerbation of fatigability in patients with aMCI with below-mean CR. Therefore, improving sleep-wake regulation and leisure activities may protect against fatigability and cognitive decline. Clinical fatigue and fatigability cannot be alleviated by rest. Clinical fatigability disrupts daily activities during preclinical Alzheimer's. High cognitive reserve mitigates sleep-wake disturbance effects. High cognitive reserve attenuates clinical fatigability effects on daily functioning. Untreated obstructive sleep apnea potentiates Alzheimer's pathology in the brain.

Comparison of Cognitive Reserve, Depression and Anxiety in Patients with Diabetes Mellitus

Aim: Few studies have comprehensively examined the cognitive reserve in patients with Diabetes Mellitus (DM). The purpose of this study was to compare cognitive reserve, depression, and anxiety in patients with DM.. Material and Methods: A prospective cross-sectional study was conducted with a total of 80 participants (40 with DM and 40 with healthy controls). Patients with DM diagnosed at a hospital's internal medicine outpatient clinic were included. Patients’ cognitive reserve was evaluated with Cognitive Reserve Index Questionnaire (CRI). Depression and anxiety of the individuals were assessed with Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), respectively. The difference between the groups was analyzed by independent sample t-test. In addition, Pearson's correlation coefficient was used to assess the relationship between the parameters. Results: Individuals with DM had significantly lower CRI-total (p=0.009) and CRI-education (p=0.011) scores. In addition, BDI (p=0.001) and BAI (p=0.019) scores were higher in individuals with DM. Correlational analyses showed a statistically significant weak negative correlation between BDI and CRI-total (r=-0.373, p=0.001), CRI-education (r=-0.294, p=0.008) and CRI-work (r=-0.386, p=0.001) scores in individuals with DM. Conclusion: The results of the present study revealed a lower cognitive reserve (particularly education-related component) in patients with DM. Besides, depression and anxiety were higher in individuals with DM than in healthy controls. In participants with DM, depression was associated with cognitive reserve (except leisure time).

Small vessel disease and cognitive reserve oppositely modulate global network redundancy and cognitive function: A study in middle-to-old aged community participants.

Cerebral small vessel disease (SVD) can disrupt the global brain network and lead to cognitive impairment. Conversely, cognitive reserve (CR) can improve one's cognitive ability to handle damaging effects like SVD, partly by optimizing the brain network's organization. Understanding how SVD and CR collectively influence brain networks could be instrumental in preventing cognitive impairment. Recently, brain redundancy has emerged as a critical network protective metric, providing a nuanced perspective of changes in network organization. However, it remains unclear how SVD and CR affect global redundancy and subsequently cognitive function. Here, we included 121 community-dwelling participants who underwent neuropsychological assessments and a multimodal MRI examination. We visually examined common SVD imaging markers and assessed lifespan CR using the Cognitive Reserve Index Questionnaire. We quantified the global redundancy index (RI) based on the dynamic functional connectome. We then conducted multiple linear regressions to explore the specific cognitive domains related to RI and the associations of RI with SVD and CR. We also conducted mediation analyses to explore whether RI mediated the relationships between SVD, CR, and cognition. We found negative correlations of RI with the presence of microbleeds (MBs) and the SVD total score, and a positive correlation of RI with leisure activity-related CR (CRI-leisure). RI was positively correlated with memory and fully mediated the relationships between the MBs, CRI-leisure, and memory. Our study highlights the potential benefits of promoting leisure activities and keeping brain redundancy for memory preservation in older adults, especially those with SVD.

Correlations between cognitive reserve, gray matter, and cerebrospinal fluid volume in healthy elders and mild cognitive impairment patients.

To explore the effect of cognitive reserve (CR) on brain volume and cerebrospinal fluid (CSF) in patients with mild cognitive impairment (MCI) and healthy elders (HE). 31 HE and 50 MCI patients were collected in this study to obtain structural MRI, cognitive function, and composite CR scores. Educational attainment, leisure time, and working activity ratings from two groups were used to generate cognitive reserve index questionnaire (CRIq) scores. The different volumes of brain regions and CSF were obtained using uAI research portal in both groups, which were taken as the regions of interest (ROI), the correlation analysis between ROIs and CRIq scores were conducted. The scores of CRIq, CRIq-leisure time, and CRIq-education in HE group were significantly higher than patients in MCI group, and the montreal cognitive assessment (MoCA) and minimum mental state examination (MMSE) scores were positively correlated with the CRIq, CRIq-education in both groups, and were positively correlated with CRIq-leisure time in MCI group. The scores of auditory verbal learning test (AVLT) and verbal fluency test (VFT) were also positively correlated with CRIq, CRIq-leisure time, and CRIq-education in MCI group, but the score of AVLT was only positively correlated with CRIq in HE group. Moreover, in MCI group, the volume of the right middle cingulate cortex and the right parahippocampal gyrus were negatively correlated with the CRIq, and the volume of CSF, peripheral CSF, and third ventricle were positively correlated with the CRIq-leisure time score. The result of mediation analysis suggested that right parahippocampal gryus mediated the main effect of the relationship between CRIq and MoCA score in MCI group. People with higher CR show better levels of cognitive function, and MCI patients with higher CR showed more severe volume atrophy of the right middle cingulate cortex and the right parahippocampal gyrus, but more CSF at a given level of global cognition.

Vocabulary knowledge as a reliable proxy of cognitive reserve in multiple sclerosis: a validation study.

The present study aimed to explore the suitability of the vocabulary knowledge (VOC) test as an accurate and reliable proxy of cognitive reserve(CR) by evaluating its psychometric properties and discrimination accuracy compared with other CR measures in multiple sclerosis (MS). Sixty-eight consecutive people with multiple sclerosis (pwMS), followed at our MS outpatient clinic, completed a clinical evaluation and neuropsychological assessment including: VOC, Brief Repeatable Battery of Neuropsychological Tests (BRB-N), Cognitive Reserve Index Questionnaire (CRIq), Beck Depression Inventory-II, and State-Trait Anxiety Inventory. Reliability, convergent and divergent validity, and discrimination accuracy of the VOCwere assessed using educational level as reference standard. The possible effects of sociodemographic and clinical factors on VOC and their role in predicting global cognitive status were also explored. VOC demonstrated good internal consistency (Cronbach's α = 0.894) and adequate construct validity. It showed an acceptable level of discrimination between pwMS with high and low CR, comparable to the CRIq score. Education strongly affected VOC scores, whichin turn were independent of MS features. VOC emerged as an independent predictor of global cognitive status together with MS-related disability. We demonstrated the validity of VOC as a reliable CR measure in pwMS. Thus, CR may alsobe estimated using fixed objective measures, independent of brain pathology and clinical features. Early CR estimation may help clinicians identify pwMS ata higher risk of cognitive decline and plan strict neuropsychological monitoring and cognitive interventions.

Cognitive Impairment in Renal Replacement Therapy: Comparison between Methods

Cognitive impairment (CI) can be defined as a clinical syndrome characterized by a decline in at least two of several domains of cognitive function. Chronic kidney disease (CKD) is an independent risk factor for cognitive decline, and the prevalence in patients with end-stage renal disease is estimated at 50% - 80%. However, it appears that CI in patients on renal replacement therapy (RRT) may be underdiagnosed. In this cross-sectional study, 33 patients on Peritoneal Dialysis from the AOU Federico II were recruited, and matched by sex, age, and dialysis age to 33 patients on Hemodialysis and 33 controls belonging to healthy volunteers. The total 66 patients and their 33 controls were assessed for cognitive function using the Cognitive Reserve Index Questionnaire (CRIq) test. Between PD and HD patients, a statistically significant difference emerged in all subscores and in the total CRI. Between PD patients and controls, a statistically significant difference emerged in education, CRI- CRI-leisure time, and the total CRI. Therefore, CI may occur in patients undergoing PD earlier and with a greater frequency than in the general population, but with a lower incidence than in patients on HD. These considerations should be communicated to patients when they are educated about different replacement methods.

Relationship between lifestyle proxies of cognitive reserve and cortical regions in older adults.

With the rapid increase in the population over 65 years old, research on healthy aging has become one of the priorities in the research community, looking for a cost-effective method to prevent or delay symptoms of mild cognitive disorder or dementia. Studies indicate that cognitive reserve theory could be beneficial in this regard. The aim of this study was to investigate the potential relationship between lifestyle socio-behavioral proxies of cognitive reserve and cortical regions in adults with no subjective cognitive decline. Overall, 58 participants, aged 65-85 years, were included in the data analysis (M = 71.83, SD = 5.02, 20.7% male). Cognitive reserve proxies were measured using the Cognitive Reserve Index questionnaire, while cortical volumes were obtained with the Siemens 1.5 T Avanto MRI scanner and further mapped using the Desikan-Killiany-Tourville (DKT) Atlas. Estimated intracranial volume and age were used as covariates. The results indicated that higher occupational complexity was associated with larger cortical volume in the left middle temporal gyrus, the left and right inferior temporal gyrus, and the left inferior parietal lobule, while a combined proxy (the total CRI score) showed a positive relationship with the volume of left middle temporal gyrus and inferior parietal lobule, and pars orbitalis in the right hemisphere. These results might indicate that more complex occupational activities and overall more intellectually and socially active life-style could contribute to better brain health, especially in regions known to be more vulnerable to Alzheimer's disease.

Validation of the Cognitive Reserve Index Questionnaire (CRIq) in Arabic.

Cognitive reserve is the adaptability of cognitive processes in the face of brain aging and pathology. This study aimed to validate the Arabic version of the Cognitive Reserve Index Questionnaire (CRIq) in a healthy Lebanese sample. CRIq assesses cognitive reserve through three domains: education, working activity, and leisure time. Statistical measures, including descriptive and regression analysis along with structural equation modeling, were utilized to investigate the convergent and discriminant validity of the CRIq, incorporating fluid intelligence (Gf) and measures of cognitive function, long-term memory encoding and retrieval (Glr), and processing speed (Gs). Results from 174 participants revealed that the activities assessed by the CRIq-Arabic were comparable to the original CRIq study, with slight cultural differences. The internal consistency of the CRIq-Arabic was good (Cronbach's α = 0.88), indicating reliability. Convergent validity was confirmed, with moderate to high loadings on the cognitive reserve latent construct. Discriminant validity was supported as correlations between cognitive reserve variables and non-target constructs (Gf, Glr, and Gs) were less than 1. The findings provide an initial psychometric validation of the CRIq-Arabic. Further research of clinical samples is needed to enhance its utility in neuropsychological practice.

The association between cognitive reserve and age‐related neuroimaging features in homozygous APOE ε4 carriers

AbstractBackgroundAlzheimer’s disease (AD) is the most common neurodegenerative dementia syndrome, which is characterized by irreversibly progressive cognitive decline, neuropsychiatric symptoms, and impaired function of independent daily living. The majority of AD occurs in individuals aged over 65 years and is termed late‐onset AD. The apolipoprotein E (APOE) ε4 allele is the highest individual risk factor. Despite lifelong influences of APOE ε4, not all APOE ε4 carriers develop cognitive decline, some APOE ε4 carriers appear to be better than others in maintaining structural and functional properties of their brains while aging. Although previous studies showed that the AD patients with higher levels of cognitive reserve had more advanced Alzheimer’s type pathology in the comparable clinical severity, the underlying mechanism is unclear. Thus, the association between the individual’s cognitive reserve and the aging‐related brain pathologies need further investigation.MethodThis study recruited dementia free homozygous APOE ε4 allele carriers and all participants’ cognitive statuses were evaluated by neuropsychological tests. Cognitive reserve was evaluated by Cognitive Reserve Index questionnaire (CRIq). In neuroimage study, we collected brain MRI images and analyzed the severity of hippocampal atrophy and white matter hyperintensities (WMH). The relationship between different kinds of cognitive reserve and age‐related neuroimaging findings were analyzed.ResultIn total, 39 participants carrying two APOE ε4 alleles were analyzed, with an average age of 61.5 years, an education level of 13.1 years, and an average MMSE of 26.4 points. Correlation analysis showed significant associations between CRI and neuropsychological tests, especially in short‐term memory, visuospatial function, and language function tests. In neuroimaging analysis, CRI‐education was associated with hippocampal atrophy, which suggested more education might help to prevent the hippocampal atrophy. The correlation between WMH severity of brain MRI and the CRI was not statistically significant.ConclusionCognitive reserve is associated with the cognitive function in dementia free homozygous APOE ε4 allele carriers and education might prevent hippocampal atrophy.

P159: Low Cognitive Reserve as a Risk Factor for Delirium in Elderly: A Case-Control Study

Objective:Cognitive Reserve (CR) developed from observation that several individuals show fewer cognitive impairment compared to others with the same brain injuries or neuropathology. Cognitive reserve is a potentially modifiable characteristic. Most of studies on cognitive reserve were conducted on chronic progressive diseases such as dementia. This study aims to define the role of cognitive reserve in geriatric delirium cases.Methods:This case-control study was conducted in the acute geriatric inpatient of Cipto Mangunkusumo Hospital, Jakarta, Indonesia on June to September 2019 that consisted of 33 subjects with delirium and 33 controls. The measurement of cognitive reserve was done using the Indonesian adaptation of Cognitive Reserve Index questionnaire (CRIq) with 3 subscales, i.e. Education, Work Activity and Leisure Time.Results:We found that the CRIq scores of delirium patients were lower compared to the non-delirium controls both on total and each subscores, with a statistically significant mean difference (p&lt;0,01). Patients with low-medium cognitive reserve also more likely to develop delirium compared to those with medium-high cognitive reserve (OR 9; 95% CI 2.86 to 28.22).Conclusion:Low cognitive reserve may serve as a risk factor for delirium in the elderly. The measure of CRI in the geriatric inpatients unit can be used to determine those at risk of developing delirium. Further research are warranted to elaborate potentially modifiable variables of cognitive reserve to minimize the risk of delirium.

Exploring the relationship between cognitive frailty and cognitive reserve in SCD and MCI

AbstractBackgroundCognitive frailty (CF) has been defined as the simultaneous presence of physical frailty (PF) and subjective or objective cognitive impairment, with current definitions differentiating, respectively, between reversible and potentially reversible CF. The former is indicated by subjective cognitive decline (SCD) and the latter by Mild Cognitive Impairment (MCI). Although CF is an emerging topic in the study of cognitive ageing, its relationship with cognitive reserve (CR) proxies have not been established.MethodThe prevalence of CF and the characterization of the sample in terms of its level of CR was studied in the second cohort of the Compostela Ageing Study (CompAS). 150 participants of the second follow‐up of this cohort who completed the PF assessment were studied. The frailty phenotype was used to operationalize the level of PF of the participants. Weakness was measured by 3 measurements of the grip strength (GS) in the dominant hand. Slow gait speed was measured through a timed‐up and go (TUG) task. Low physical activity was measured with the Spanish version of the Minnesota Physical Activity Questionnaire (VREM). MCI and SCD were diagnosed using the current criteria. The level of CR was established using the scores of the Cognitive Reserve Index questionnaire (CRIq). Bivariate correlations were made between CRIq subscales scores and the results in GS, TUG and VREM.ResultsA higher percentage of high CR was observed in participants without frailty, and a higher percentage of participants with medium level of CR showed pre‐frailty (c2 = 27,96 p&lt;.05). Significant moderate correlations were obtained between GS and CRI‐q working activity (r = .47), and between TUG and CRI‐q leisure time (r = ‐.35).ConclusionAs expected for a risk factor for dementia, there were significant relationships between CF and several domains of CR. Future longitudinal analysis should analyze the capacity of the CR to attenuate or delay the onset of cognitive frailty.

Effects of Physical Activity on Cognitive Functioning: The Role of Cognitive Reserve and Active Aging.

The increase in average life expectancy necessitates the identification of possible mechanisms capable of promoting "active aging" to ensure adequate levels of global functioning. Numerous studies show that regular physical activity promotes, even in the elderly, a state of functional psychophysical well-being capable of slowing down age-related cognitive decline. This study aimed to clarify whether, and how, the intensity of physical activity can modulate cognitive and executive skills by influencing specific psychological variables. Our sample consisted of 151 senior subjects divided into hikers (HIK), gentle gymnastics (GYM), and sedentary (SED), who practice intense, moderate, and reduced physical activity, respectively. A battery of psychological questionnaires was administrated to evaluate attentional skills, decision-making, the ability to implement targeted behaviors, perceived self-efficacy, and psychophysical well-being. We included: the Mini-Mental State Examination, Cognitive Reserve Index Questionnaire, General Self-Efficacy Scale, Letter Cancellation Test, Everyday Competence Questionnaire, and Geriatric Depression Scale (GDS). Comparisons between the scores reported by the three groups showed that the HIK group differs from the others with respect to most of the measurements, presenting better mood and cognitive performance, and a specific psychological profile. On the contrary, the GYM group appeared to have a greater affinity with the SED group than with the HIK group, both cognitively and psychologically. Types of physical activity, as well as the intensity and frequency with which they are practiced, are factors that promote an active aging process, protecting the psychophysical well-being and overall cognitive functioning of the elderly.

The Cognitive Profile of Elderly Patients With Mild Traumatic Brain Injury: A Role for Cognitive Reserve?

To assess cognitive status in elderly patients with mild traumatic brain injury (mTBI) in the subacute phase, examine the role of cognitive reserve, and investigate associations with cognitive complaints, mental distress, and functional outcomes. A level 1 trauma center in the Netherlands. A total of 52 individuals with mTBI and 42 healthy controls. A prospective observational cohort study. Neuropsychological assessment in the subacute phase (2 weeks to 6 months post-injury) to objectively measure the cognitive functioning, the Head Injury Symptom Checklist for subjective cognitive complaints, the Hospital Anxiety and Depression Scale for anxiety and depression, the Cognitive Reserve Index questionnaire for cognitive reserve, the Community Integration Questionnaire for community integration, and the Glasgow Outcome Scale Extended for functional outcome. Cognitive impairments were observed in memory (P < .001) and attention, processing speed and executive control (P < .001). Cognitive reserve was not associated with neuropsychological test performance, except for one test measuring working memory. The relationship between injury severity and cognitive outcome was not moderated by cognitive reserve. Elderly patients reported significantly more complains than healthy controls regarding forgetfulness, concentration problems, and slowness. Complaints of concentration were associated with cognitive impairment. All cognitive complaints were significantly correlated with mental distress. Cognitive impairments may be present in elderly patients in the subacute phase after mTBI, and these impairments were not significantly associated with cognitive reserve. This suggests that cognitive reserve might not serve as a protective factor against the effects of mTBI in the elderly. Concentration complaints may serve as a specific indicator for cognitive impairment, while complaints of memory and mental slowness may represent more generic indicators of mental distress. These findings highlight the importance of careful screening in older adults with mTBI, guiding clinicians toward specific treatment targets encompassing cognitive impairment, diminished mental well-being, or both.

A - 07 The Role of Age and Cognitive Reserve in Moderating the Cognitive Effects of Chemotherapy.

The aim of this exploratory study is to assess the cognitive effects of chemotherapy (CT) in women with breast cancer and to understand the role of age and cognitive reserve (CR) in the development of these effects. A group of women with early breast cancer with indication for CT (n = 32) and a group of healthy subjects (n = 32) were recruited. Both groups performed neuropsychological assessment at two time points- at baseline (before the initiation of CT and 6months later). Additionally, Cognitive Reserve Index questionnaire (CRIq), a comprehensive measure of CR, was applied. The cognitive tests were combined in a unique z-score for attention and executive function domain. The longitudinal cognitive assessment was analyzed using a mixed effect modeling approach with patient's vs controls as grouping factor and adjusted for age, CR, years of education and baseline cognitive performance as fixed factors. Mean age and education years for both groups were 49 (SD ± 8) years and 17 (SD ± 3), respectively. The level of CR was equally distributed across both samples, with 75% of participants presenting a high level of CR. The mixed effects model analysis did not show a significant effect for group. For Attention, a three-way interaction among CR, age and years of education was significant (p = 0.04). For the executive functions, none of the factors were significant. Our results suggest that CT did not contribute significantly for the development of cognitive decline in cancer patients. However, age, years of education and CR have a joint impact on attention, but not executive functions.

Over ninety years old: Does high cognitive reserve still help brain efficiency?

Nonagenarians and centenarians, also called oldest-old, are a very heterogeneous population that counts a limited number of individuals as it is a real challenge to reach this goal. Even if it is well known that cognitive reserve can be considered a factor in maintaining good cognitive functioning in ageing, only very few studies have been carried out on the role of cognitive reserve (CR) in the oldest-old people. The aim of this study is to investigate the relationship between cognitive reserve and cognitive functioning in a population living in a specific region of Italy, the Blue Zone in Sardinia. This population is characterised by extreme longevity and distinctive historical, geographic, social, linguistic and nutritional features. The cognitive Reserve Index questionnaire (CRIq) and the short cognitive Esame Neuropsicologico Breve-2 (ENB-2, Brief Neuropsychological Examination) were administered to 67 participants, all aged between 90 and 105 years old. The CRIq was a predictor of neuropsychological performance for the global score of the battery of tests, ENB-2 (ENB-tot) and also for 7 out of 16 of its sub-tests. All except one (Token) tapped executive functions (Interference memory at 10 and 30 s, TMT-B, Overlapping figures, ion, Fluency). Results highlight that also in the oldest-old population CR has a positive effect on cognition, especially on executive functioning.

The rising role of cognitive reserve and associated compensatory brain networks in spinocerebellar ataxia type 2

Pre-existing or enhanced cognitive abilities influence symptom onset and severity in neurodegenerative diseases, which improve an individual’s ability to deal with neurodegeneration. This process is named cognitive reserve (CR), and it has acquired high visibility in the field of neurodegeneration. However, the investigation of CR has been neglected in the context of cerebellar neurodegenerative disorders. The present study assessed CR and its impact on cognitive abilities in spinocerebellar ataxia type 2 (SCA2), which is a rare cerebellar neurodegenerative disease. We investigated the existence of CR networks in terms of compensatory mechanisms and neural reserve driven by increased cerebello-cerebral functional connectivity. The CR of 12 SCA2 patients was assessed using the Cognitive Reserve Index Questionnaire (CRIq), which was developed for appraising life-span CR. Patients underwent several neuropsychological tests to evaluate cognitive functioning and a functional MRI examination. Network based statistics analysis was used to assess functional brain networks. The results revealed significant correlations of CRIq measures with cognitive domains and patterns of increased connectivity in specific cerebellar and cerebral regions, which likely indicated CR networks. This study showed that CR may influence disease-related cognitive deficits, and it was related to the effective use of specific cerebello-cerebral networks that reflect a CR biomarker.

Cognitive reserve index and long-term disability in patients with severe traumatic brain injury discharged from the intensive rehabilitation unit.

The "cognitive reserve" (CR) theory posits that higher premorbid cognitive activities can mitigate the effects of brain damage. This study aimed to investigate the association between CR and long-term functional autonomy in patients surviving a severe traumatic brain injury (sTBI). Data were collected from the database of inpatients with severe acquired brain injury in a rehabilitation unit admitted from August 2012 to May 2020. Patients that had incurred an sTBI, aged 18+ years, completing the phone Glasgow Outcome Scale-Expanded at follow-up (pGOS-E) in absence of previous brain trauma or neurological disease, or cognitive disorders were included. Patients with severe brain injury from non-traumatic etiologies were not included in the study. In this longitudinal study, all patients underwent a multidimensional assessment including the cognitive reserve index questionnaire (CRIq), the coma recovery scale-revised, the level of cognitive functioning, the Disability Rating Scale (DRS), and the Galveston Orientation and Amnesia Test at admission. At discharge, functional scales were administered again together with the Glasgow Outcome Scale. The pGOS-E was assessed at follow-up. pGOS-E. A total of 106 patients/caregivers underwent the pGOS-E after 5.8 [3.6] years from the event. Among them, 46 (43.4%) died after discharge, and 60 patients [men: 48 (80%); median age: 54 years; median time post-onset: 37 days; median education level: 10 years; median CRIq total score: 91] were included in the analysis exploring the association between pGOS-E and demographic data, cognitive reserve surrogates, and clinical variables at admission and discharge from the rehabilitation unit. A younger age (B = -0.035, p = 0.004) and a lower DRS category at discharge (B = -0.392, p = 0.029) were significantly related to a higher long-term functional autonomy in the multivariate analysis. Long-term functional autonomy was not influenced by CR as assessed through the educational level and the CRIq.

How long have you exercised in your life? The effect of motor reserve and current physical activity on cognitive performance.

Aging of the population encourages research on how to preserve cognition and quality of life. Many studies have shown that Physical Activity (PA) positively affects cognition in older adults. However, PA carried out throughout the individual's lifespan may also have an impact on cognition in old age. We hypothesize the existence of Motor Reserve (MR), a flexible and dynamic construct that increases over time and compensates for age-related motor and cognitive loss. Two questionnaires were developed and validated to estimate MR (Physical Activity carried out throughout the individual's lifespan) and Current Physical Activity (CPA, PA carried out in the previous 12 months). They were administered to 75 healthy individuals over 50 to verify the relation with cognition. MR and CPA include physical exercise (i.e., structured activities to improve or maintain physical fitness) and incidental PA, which we consider as any movement that leads to a metabolic cost above baseline (e.g., housekeeping, walking). In addition, the Cognitive Reserve Index questionnaire (CRI), a reliable predictor of cognitive performance, was used to measure each participant's Cognitive Reserve. The factors that most influenced performance are Age and Cognitive Reserve, but also MR and CPA together and MR when it is the only factor. Cognitive variability in adult and elderly populations is explained by both MR and CPA. PA training could profitably be included in new preventive and existing interventions.

Gender-Related Differences in the Correlation between Odor Threshold, Discrimination, Identification, and Cognitive Reserve Index in Healthy Subjects.

Many studies suggested that olfactory function could be associated with semantic memory, executive function, and verbal fluency. However, the gender-related association between olfactory function and the cognitive domain is not well investigated. The aim of this study was to estimate gender-related differences in the relationship between olfactory function and each specific cognitive domain of the Cognitive Reserve Index (CRI) questionnaire, such as education, working activity, and leisure time in healthy subjects. Two hundred and sixty-nine participants were recruited (158 women and 111 men), with a mean age of 48.1 ± 18.6 years. The CRI questionnaire and Sniffin' Sticks test were used to evaluate the cognitive reserve and the olfactory function, respectively. In all subjects, significant associations between the odor threshold versus CRI-Education, between the odor discrimina-tion and identification versus CRI-Working activity and CRI-Leisure Time, were found. In women, odor threshold, discrimination, and identification were associated with CRI-Leisure Time, while in men, only a significant association between odor threshold and CRI-Education was observed. Our data, showing significant gender-related associations between olfactory function and CRI scores, suggested the use of olfactory evaluation and cognitive reserve as an important screening tool for the early detection of mild cognitive impairment.