Alzheimer's art

What is meant by cognitive reserve?

Cognitive reserve is the mind’s resistance to damage to the brain.

It is an evidence-based idea proposed by Columbia University neuropsychologist Dr. Yaakov Stern in the mid-1990s which described individuals with no apparent symptoms of dementia who were nonetheless found at autopsy to have a brain consistent with advanced Alzheimer’s disease. They found that these individuals did not show symptoms of the disease while they were alive because they had had large enough cognitive reserve to offset damage and continue to function as usual. Essentially, individuals can develop a reserve of thinking abilities during their lives which protect them against losses that can occur through aging and dementia.

Research has shown that individuals with greater cognitive reserve are better able to stave off degenerative brain changes associated with Alzheimer’s or other dementias. Lifetime exposures to educational and occupational attainments and leisure activities later in life can increase reserve. For example, studies have shown that there is a reduced risk of developing Alzheimer’s disease in individuals with higher educational or occupational achievements.

It is never too late to build cognitive reserve. Early exposures to enriched environments provide the strongest effects, but leisure activities in older adulthood can also increase the reserve. Activities that engage the brain such as reading, learning a new language, visiting with friends and family, going to movies and restaurants, and attending community social events are all strongly related to gains in cognitive reserve and a reduced risk of dementia. It is important to note that it is cumulative behavior changes across all aspects of health (physical, cognitive, and social) that promote cognitive reserve.

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Physical activity plays an important role in building cognitive reserve. A diverse aerobic program builds fitness, strength, balance training and increase flexibility. Research has shown that a multicomponent exercise program that combined aerobic, strength and balance training in older adults with mild cognitive impairment demonstrated improved memory.

Cognitive skills are not fixed. On the contrary, at all ages the brain has the ability to respond to new information and new stimuli, to seek out and embrace things that challenge the brain.

Individuals should engage their minds outside established domains, meaning that if they always worked crossword puzzles, they should try something outside their realm. Other examples of developing cognitive reserve include changing routes while going to regular venues, such as grocery shopping or to a faith establishment. Using the non-dominant hand for activities such as eating or brushing teeth are challenging practices and can help preserve mental capacity. Examining problems from different perspectives and changing points of view will also exercise the brain.

The internet is full of various websites that offer video lectures and courses that can flex mental muscles. Traveling to new places, exploring personal strengths and weaknesses, expanding on existing talents, and learning a new hobby or learning to play a new musical instrument are all ways that not only build mental and physical capacities but also develop cognitive reserve.