Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA.
Faculty of Epidemiology, Colorado School of Public Health, Fort Collins, CO, USA.
J Int Neuropsychol Soc. 2024 Oct;30(8):746-754. doi: 10.1017/S1355617724000353. Epub 2024 Sep 18.
Cognitive reserve (CR) is typically operationalized as episodic memory residualized on brain health indices. The dimensionality of more generalized models of CR has rarely been examined.
In a sample of = 113 dementia-free older adults (ages 62-86 years at MRI scan; 58.4% women), the domain-specific representation of general cognition (COG) before vs. after residualization on brain indices (brain volume loss, cerebral blood flow, white matter hyperintensities) was compared (i.e., COG vs. CR). COG and CR were assessed by 15 tasks spanning five domains: processing speed, verbal memory, visuospatial memory, fluid reasoning, and vocabulary. Measurement invariance and item-construct representation were tested in a series of structural factor analyses. COG and CR were then examined in relation to 22 risk and protective factors and dementia status at time of death.
Item-factor loadings differed such that CR more strongly emphasized fluid reasoning. More years of education, higher occupational class, more hobbies/interests, and fewer difficulties with personal mobility similarly predicted better COG and CR. Only the sub-domain of visuospatial memory (both before and after residualization) was associated with conversion to dementia by end-of-life ( = -.30; = .01).
Results provide tentative support for the role of fluid reasoning (intelligence) as a potential compensatory factor for age- and/or neuropathology-related reductions in processing speed and memory. Intellectually stimulating work, efforts to preserve personal mobility, and a diversity of hobbies and interests may attenuate age- and/or pathology-related reductions in cognitive functioning prior to dementia onset.
认知储备（CR）通常被定义为与大脑健康指标相关的情景记忆残留。更广泛的 CR 模型的维度很少被检验。
在一个无痴呆的老年人样本中（MRI 扫描时年龄为 62-86 岁；58.4%为女性），比较了在大脑指数（脑体积损失、脑血流、白质高信号）上进行剩余化前后的特定领域一般认知（COG）的表现（即 COG 与 CR）。COG 和 CR 通过 15 项任务进行评估，涵盖五个领域：处理速度、言语记忆、视空间记忆、流体推理和词汇。在一系列结构因子分析中测试了测量不变性和项目结构表示。然后，在 22 个风险和保护因素以及死亡时的痴呆状况下，检查了 COG 和 CR。
项目因子负荷不同，CR 更强调流体推理。受教育年限更长、职业阶层更高、爱好/兴趣更多、个人行动困难更少，同样可以预测 COG 和 CR 更好。只有视空间记忆子域（无论是在剩余化之前还是之后）与生命末期的痴呆转化有关（= -.30；=.01）。
结果初步支持流体推理（智力）作为与年龄和/或神经病理学相关的处理速度和记忆下降的潜在补偿因素的作用。智力刺激的工作、努力保持个人行动能力以及多样化的爱好和兴趣，可能会在痴呆发病前减轻与年龄和/或病理学相关的认知功能下降。
