Cognitive reserve in the healthy elderly: cognitive and psychological factors

Cognitive reserve (CR) helps explain the mismatch between expected cognitive decline and observed maintenance of cognitive functioning in older age. Factors such as education, literacy, lifestyle, and social networking are usually considered to be proxies of CR and its variability between individuals. A more direct approach to examine CR is through the assessment of capacity to gain from practice in a standardized challenging cognitive task that demands activation of cognitive resources. In this study, we applied a testing-the-limits paradigm to a group of 136 healthy elderly subjects (60–75 years) and additionally examined the possible contribution of complex mental activities and quality of sleep to cognitive performance gain. We found a significant but variable gain and identified verbal memory, cognitive flexibility, and problem-solving as significant factors. This outcome is in line with our earlier study on CR in healthy mental aging. Interestingly and contrary to expectations, our analysis revealed that complex mental activities and sleep quality do not significantly influence CR. Contrasting “high” and “low” cognitive performers revealed significant differences in verbal memory and cognitive flexibility; again, complex mental activities and sleep quality did not contribute to this measure of CR. In conclusion, the results of this study support and extend previous findings on CR in older age; further, they underline the need for improvements in existing protocols for assessing CR in a dynamic manner