Montemurro Sonia, Rumiati Raffaella Ida, Pucci Veronica, Nucci Massimo, Mondini Sara
Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padua, Padua, Italy.
Neuroscience, SISSA, Trieste, Italy.
Aging Clin Exp Res. 2025 Mar 17;37(1):93. doi: 10.1007/s40520-025-03000-z.
Trajectories of decline from healthy aging to dementia are not linear; they may range from a more attenuated to a more accelerated cognitive worsening. This longitudinal study investigates the impact of Cognitive Reserve (CR) on task performance in a cohort of 117 individuals (mean age 74.89; SD = 7.43) who experienced difficulties in everyday life and referred to a neuropsychology unit for cognitive assessment. Only participants assessed three times were included in the study. CR was estimated for each participant based on educational level and occupational complexity. Results revealed a general decline in global cognitive performance over time, in particular from the second to the final assessment (mean years = 2.95 ± 2.11). The two groups (high CR vs. low CR) did not differ for sex or age across assessments. Individuals with high CR not only exhibited greater cognitive efficiency at baseline-consistent with Stern's (2009) construct-but also maintained a more stable cognitive state over time compared to those with low CR. Post-hoc analyses confirmed that while the two groups did not differ in task performance between the first and the second assessment, they significantly differed from the second to the third. Individuals with high CR (even those who were diagnosed with a major neurocognitive disorder) preserved their cognitive profile whereas the profile of those with low CR declined significantly. This study demonstrates that cognitive trajectories are shaped by CR and that, despite the plausible progression of brain deterioration, individuals with high CR may not experience an accelerated cognitive deterioration. Instead, they may exhibit a more gradual decline and sustain cognitive functioning for a longer period despite age-related changes.
从健康衰老到痴呆的衰退轨迹并非呈线性；其范围可能从较为缓慢到较为快速的认知恶化。这项纵向研究调查了认知储备（CR）对117名个体（平均年龄74.89岁；标准差=7.43）任务表现的影响，这些个体在日常生活中存在困难，并被转介到神经心理学科室进行认知评估。该研究仅纳入了接受三次评估的参与者。根据教育水平和职业复杂性为每位参与者估算CR。结果显示，随着时间推移，整体认知表现普遍下降，尤其是从第二次评估到最后一次评估（平均时长=2.95±2.11年）。在各次评估中，两组（高CR组与低CR组）在性别或年龄方面并无差异。与低CR个体相比，高CR个体不仅在基线时表现出更高的认知效率——这与斯特恩（2009年）的构想一致——而且随着时间推移保持了更稳定的认知状态。事后分析证实，虽然两组在第一次和第二次评估之间的任务表现没有差异，但从第二次评估到第三次评估存在显著差异。高CR个体（即使是那些被诊断患有重度神经认知障碍的个体）保持了他们的认知状况，而低CR个体的认知状况则显著下降。这项研究表明，认知轨迹受CR影响，并且，尽管大脑退化可能合理进展，但高CR个体可能不会经历加速的认知退化。相反，尽管存在与年龄相关的变化，他们可能表现出更缓慢的衰退，并在更长时间内维持认知功能。
