Cognitive reserve is an important multi-dimensional concept that is beneficial to understand for preserving the health of your brain for as long as possible. It provides the best chance for fighting back against normal brain aging and age-associated brain disorders, like dementia.
Cognitive reserve is an evidence-based idea proposed by Columbia University neuropsychologist Dr. Yaakov Stern in the mid 1990s. It was inspired by a series of autopsy studies that revealed advanced pathological symptoms of Alzheimer’s disease (amyloid plaques and neurofibrillary tangles) in the brains of some subjects who did not show symptoms of the disease in real life. Researchers initially thought this was due to a type of physical brain reserve after realizing that the people had larger brains than their counterparts. This was based on the assumption that they had more brain cells to lose and could, therefore, tolerate more brain disease before they showed the effects in life.
Stern agreed with the study findings but took his explanation to the next level when he stated that the real contribution was a process of active compensation due to stronger brain cell connections. He called his theory cognitive reserve. Stern and other brain researchers spent the last few decades studying what life experiences make the biggest contributions to cognitive reserve. Some highlights of their findings include:
It’s all about an enriched environment. The most important thing to understand about cognitive reserve is that it is a result of many types of brain-friendly activities, including physical activity, new and complex learning, social interaction and diet. Relying on one intervention for brain health, like one brain game or a single supplement, is one of the fundamental errors of the majority of brain health products on the market today. Science tells us that healthy brains result from enrichment in all aspects of health. Enriched environments are defined as those offering increased opportunities for physical activity, learning, and social interaction. It is thought that these experiences encourage the growth of new brain cells and their connections, a process called neurogenesis, that allows for multiple “back up” systems for thinking, problem-solving and memory.
The almighty exercise: The influence of aerobic exercise on cognitive reserve is impressive. Cardiovascular fitness is associated with lower rates of age-related decline in brain volume, particularly in the gray matter of the brain. In one study of cognitively normal older adults, those who exercised three or more times per week were more likely to not develop dementia during the next six years, independent of other risk factors for dementia. Walking more than 72 blocks (3.6 miles) per week was the minimum determined for safeguard against age-related brain changes in another study.
It’s never too late to make a deposit in your cognitive reserve. Population-based studies have suggested that early exposures to enriched environments, including educational and occupational achievement, provide the most robust effects, but leisure activities in older adulthood can also increase this reserve. Research subjects with high engagement in leisure activities had 38 percent less risk of developing dementia in a 2001 study. Reading, visiting friends or relatives, going to movies or restaurants, and walking for pleasure or going out in the community for social events were most strongly associated with a reduced risk of dementia.
Consider these three ways to increase your cognitive reserve:
- Know that YOU can make a difference in your brain health: It’s never too late to stimulate your brain and build cognitive reserve. Science tells us this is a powerful tool in helping prevent cognitive decline, reducing the risk of developing dementia and keeping us living a life of the highest quality. Remember, it is cumulative behavior change across all aspects of health (physical, cognitive and social) that contribute to cognitive reserve. Science tells us that enriched environments result in the strongest brains, so say yes to new and stimulating experiences. Even if you won’t be totally successful at the task, there is brain-value in trying!
- Mix up your exercise routine. It is thought that a single type of exercise is not as brain-beneficial as a diverse aerobic program that builds aerobic fitness, muscular strength, balance training and increased flexibility. A recent study investigated the effects of a two-day per week multicomponent exercise program that combined aerobic, strength and balance training in older adults with mild cognitive impairment showed improved memory and maintenance of brain matter compared with the control group.
- Re-visit an old hobby. This is thought to be particularly beneficial for strengthening the brain later in life, as you are building on established brain networks that are just waiting to be awakened. After you re-establish your basic skills, keep pushing yourself to advance to the next level of mastery. Bit by bit, your brain will get stronger and stronger.
A word of caution: If you or someone you know has been diagnosed with dementia, please do not think it is because there is a lack of cognitive reserve. The expression of dementia is based on a complex interaction between genetic and lifestyle factors that are unique to each person. There are many people who will develop dementia, no matter what they do or how smart they are, because their genetic predisposition is so strong.
Dr. Sullivan, a board-certified, clinical neuropsychologist at Pinehurst Neuropsychology and creator of the I CARE FOR YOUR BRAIN program, can be reached at 910-420-8041, or by visiting www.pinehurstneuropsychology.com or www.icfyb.com.