Article

Does cognitive reserve shape cognitive decline?

INSERM, U1018, Center for Research in Epidemiology and Population Health, Paul Brousse Hospital, Villejuif, France.
Annals of Neurology (Impact Factor: 11.91). 08/2011; 70(2):296-304. DOI: 10.1002/ana.22391
Source: PubMed

ABSTRACT Cognitive reserve is associated with a lower risk of dementia, but the extent to which it shapes cognitive aging trajectories remains unclear. Our objective is to examine the impact of 3 markers of reserve from different points in the life course on cognitive function and decline in late adulthood.
Data are from 5,234 men and 2,220 women, mean age 56 years (standard deviation = 6) at baseline, from the Whitehall II cohort study. Memory, reasoning, vocabulary, and phonemic and semantic fluency were assessed 3× over 10 years. Linear mixed models were used to assess the association between markers of reserve (height, education, and occupation) and cognitive decline, using the 5 cognitive tests and a global cognitive score composed of these tests.
All 3 reserve measures were associated with baseline cognitive function; the strongest associations were with occupation and the weakest with height. All cognitive functions except vocabulary declined over the 10-year follow-up period. On the global cognitive test, there was greater decline in the high occupation group (-0.27; 95% confidence interval [CI], -0.28 to -0.26) compared to the intermediate (-0.23; 95% CI, -0.25 to -0.22) and low groups (-0.21; 95% CI, -0.24 to -0.19); p = 0.001. The decline in reserve groups defined by education (p = 0.82) and height (p = 0.55) was similar.
Cognitive performance over the adult life course was remarkably higher in the high reserve groups. However, rate of cognitive decline did not differ between reserve groups with the exception of occupation, where there was some evidence of greater decline in the high occupation group.

Download full-text

Full-text

Available from: Michael G Marmot, Aug 25, 2015
0 Followers
 · 
129 Views
  • Source
    • "Subtle alterations of cognition are common and well established in older adults, even in the absence of dementia or significant cognitive impairment. People frequently report increasing difficulties with memory and speed of thought, and research has shown that cognitive domains such as memory, processing speed, reasoning and executive functioning decline with age (Deary et al., 2009; Singh-Manoux et al., 2011). Whilst these changes are not in themselves clinically significant , they may represent the very earliest stages of decline and are potentially important targets for public health interventions. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives Emerging literature suggests that lifestyle factors may play an important role in reducing age-related cognitive decline. There have, however, been few studies investigating the role of cognitively stimulating leisure activities in maintaining cognitive health. This study sought to identify changes in cognitive performance with age and to investigate associations of cognitive performance with several key cognitively stimulating leisure activities. Method Over 65,000 participants provided demographic and lifestyle information and completed tests of grammatical reasoning, spatial working memory, verbal working memory and episodic memory. ResultsRegression analyses suggested that frequency of engaging in Sudoku or similar puzzles was significantly positively associated with grammatical reasoning, spatial working memory and episodic memory scores. Furthermore, for participants aged under 65years, frequency of playing non-cognitive training computer games was also positively associated with performance in the same cognitive domains. The results also suggest that grammatical reasoning and episodic memory are particularly vulnerable to age-related decline. Further investigation to determine the potential benefits of participating in Sudoku puzzles and non-cognitive computer games is indicated, particularly as they are associated with grammatical reasoning and episodic memory, cognitive domains found to be strongly associated with age-related cognitive decline. Conclusions Results of this study have implications for developing improved guidance for the public regarding the potential value of cognitively stimulating leisure activities. The results also suggest that grammatical reasoning and episodic memory should be targeted in developing appropriate outcome measures to assess efficacy of future interventions, and in developing cognitive training programmes to prevent or delay cognitive decline. Copyright (c) 2014 John Wiley & Sons, Ltd.
    International Journal of Geriatric Psychiatry 04/2015; 30(4). DOI:10.1002/gps.4155 · 3.09 Impact Factor
  • International Journal of Epidemiology 08/2011; 40(4):845-7. DOI:10.1093/ije/dyr114 · 9.20 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In societies with a high level of population aging, the ability to live autonomously is a major goal of public health. The present article examines recent population-based studies analyzing a possible reduction in the prevalence of disability and provides evidence on the unmet needs of dependent individuals.In the last few decades, disability and reduced mobility have decreased in elderly persons living in high-income countries, including Spain. This decrease is clear in persons aged less than 85 years old but the trends in persons older than 85 years are difficult to study due to the lack of information. These trends depend on greater education among the population, a reduction in social and gender inequalities and the adoption of healthy lifestyle habits. A reduction in dependency also depends on changes in the physical and social environment to encourage active aging. The health gains in the generation aged between 40 and 65 years do not seem high. The reductions in disability in the next 25 years will not be as great as those observed between 1990 and the present time, except for a possible reduction in disability in women due to a decrease in gender roles. Dependence on help from third persons will tend to decrease, except in dementia. Use of technical aids is increasing and will continue to do so.
    Gaceta Sanitaria 12/2011; 25 Suppl 2:12-20. DOI:10.1016/j.gaceta.2011.07.026 · 1.25 Impact Factor
Show more