A framework for concepts of reserve and resilience in aging
Open accessAbstract
The study of factors, across species, that allow some individuals to age more successfully than others has important implications for individual wellbeing as well as health education, policy and intervention. Design of studies and communication across investigators in this area has been hampered by a diversity of terminology. The Collaboratory on Research Definitions for Reserve and Resilience in Cognitive Aging and Dementia was funded by the National Institute on Aging and established in 2019 as a 3-year process of developing consensus definitions and research guidelines. The proposed Framework is based on an iterative process including 3 annual Workshops, focused workgroups, and input from numerous international investigators. It suggests the overarching term: resilience, and presents operational definitions for 3 concepts: cognitive reserve, brain maintenance, and brain reserve. Twelve pilot studies that integrate these definitions are presented. The use of a common vocabulary and operational definitions will facilitate even greater progress in understanding the factors that are associated with successful aging.
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Resilience helps mitigate the effects of aging, stress, and disease and supports cognitive vitality across life.
“In the context of lifespan and brain health, resilience has a critical role in mitigating the impacts of aging, stress and disease, promoting cognitive vitality throughout life1–5.”
From Resilience and brain health in global populations (2025) · cites this paper as [4]
The Resilience section defines resilience as the brain’s capacity to maintain cognition and function with aging and disease. The CR Definition section also describes better-than-expected cognitive performance despite life-course brain changes, injury, or disease. The paper mentions stressors as possible experimental models, but does not establish the broader claim that resilience mitigates stress or promotes cognitive vitality throughout life. Page numbers were not supplied in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredResilience is a multidimensional construct spanning biological, psychological, and social domains and is important for population health, especially brain health.
“Resilience is a multifaceted concept that spans biological, psychological and social domains, and is critical for population health—particularly brain health.”
From Resilience and brain health in global populations (2025) · cites this paper as [4]
The Resilience section defines resilience broadly in terms of the brain’s capacity to maintain cognition and function during aging and disease, and the Conclusion links the framework to lifelong brain health. The Introduction also notes implications for health education, policy and intervention. But the paper does not characterize resilience as spanning biological, psychological and social domains or make a general claim about population health. (LLM, conf=0.84)
Experimental — accuracy not yet measuredAt the biological level, resilience is the brain's capacity to adapt to aging and pathology via neuroplasticity, compensation, reserve, and allostasis, allowing sustained function despite biological challenges.
“At the biological level, resilience is the capacity of the brain to adapt to aging and pathology through mechanisms such as neuroplasticity, compensation, reserve and allostasis, allowing sustained function despite biological challenges.”
From Resilience and brain health in global populations (2025) · cites this paper as [4]
The Resilience section defines resilience as the brain’s capacity to maintain cognition and function with aging and disease, and the CR Definition describes mechanisms that help compensate for brain changes. But the paper does not identify neuroplasticity or allostasis as mechanisms of resilience, and its BR Definition says brain reserve does not involve active adaptation. No page numbers are available in our copy. (LLM, conf=0.87)
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Sex and gender differences in cognitive resilience to aging and Alzheimer's disease
Arenaza‐Urquijo, E. M., Boyle, R., Casaletto, K., Anstey, K. J., Vila‐Castelar, C., Colverson, A., Palpatzis, E., Eissman, J. M., Kheng Siang Ng, T., Raghavan, S., et al. (2024) · Alzheimer's & Dementia · doi:10.1002/alz.13844 · Cited by 223 · see citing works
Resilience and brain health in global populations
Udeh-Momoh, C. T., Migeot, J., Blackmon, K., Mielke, M. M., Melloni, M., Cox, L., Yaffe, K., Santamaria-Garcia, H., Stern, Y., & Ibanez, A. (2025) · Nature Medicine · doi:10.1038/s41591-025-03846-w · Cited by 42 · see citing works
Self-citationCortical excitability and the aging brain: toward a biomarker of cognitive resilience
Palermo, S., Di Fazio, C., Scaliti, E., Stanziano, M., Nigri, A., & Tamietto, M. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1542880 · Cited by 24 · see citing works
- Authors
- Stern, Y., Albert, M., Barnes, C. A., Cabeza, R., Pascual-Leone, A., & Rapp, P. R.
- Affiliations
- Columbia University Irving Medical Center (US)
- Johns Hopkins University (US)
- University of Arizona (US)
- Duke University (US)
- National Institute on Aging (US)
- Corresponding author
- Stern, Yaakov
- Venue
- Neurobiology of Aging
- Publisher
- Elsevier BV
- Published
- 2023-04
- Volume
- 124
- Pages
- 100-103
- ISSN
- 0197-4580 (ISSN-L)
- PMC
- PMC10424718
- OpenAlex
- W4311902677
- Cited by
- 399
- References
- 0
- Citations by year
- 2026: 128 · 2025: 140 · 2024: 88 · 2023: 41 · 2022: 2
- FWCI
- 44.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (am, 319 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- Neurobiology of Aging (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (R24 AG06142)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Keywords
- cognitive reserve, brain reserve, brain maintenance, resilience, successful aging, dementia, cognitive aging, operational definitions, terminology standardization
- MeSH terms
- Cognitive Aging, Aging, Brain, Humans, Cognitive Reserve
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