The DOI matches its Crossref record; 59 of the 59 references it cites were found in a registry or an index; 29 of the 54 sources its claims cite were checked for support.
Cognitive reserve in ageing and Alzheimer's disease
Open accessAbstract
The concept of cognitive reserve provides an explanation for differences between individuals in susceptibility to age-related brain changes or pathology related to Alzheimer's disease, whereby some people can tolerate more of these changes than others and maintain function. Epidemiological studies suggest that lifelong experiences, including educational and occupational attainment, and leisure activities in later life, can increase this reserve. For example, the risk of developing Alzheimer's disease is reduced in individuals with higher educational or occupational attainment. Reserve can conveniently be divided into two types: brain reserve, which refers to differences in the brain structure that may increase tolerance to pathology, and cognitive reserve, which refers to differences between individuals in how tasks are performed that might enable some people to be more resilient to brain changes than others. Greater understanding of the concept of cognitive reserve could lead to interventions to slow cognitive ageing or reduce the risk of dementia.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This review argues that cognitive reserve explains why people differ in how much Alzheimer’s disease pathology or age-related brain change they can tolerate while still functioning. It synthesizes epidemiologic, neuroimaging, postmortem, and intervention evidence, and concludes that reserve is modifiable but that causal interventions remain unproven.
Key findings
- Reserve is split into brain reserve, a more passive quantitative tolerance tied to brain size or neurons/synapses, and cognitive reserve, an active functional process in which pre-existing or compensatory networks help cope with damage.
- Epidemiologic studies cited found that fewer than 8 years of education carried 2.2 times higher dementia risk, low occupational attainment carried 2.25 times higher risk, and greater leisure activity was linked to 38% lower risk; a review of 22 cohort studies estimated higher reserve reduced dementia risk by 46%.
- After Alzheimer’s disease becomes clinically apparent, higher reserve is associated with faster decline: memory scores fell about one point yearly on average, with an additional point yearly in those with higher education or occupation.
- Imaging and autopsy evidence indicated that at matched clinical severity, higher education was linked to greater parietotemporal blood-flow deficit and, in 130 elders, each additional year of education reduced the pathology–cognition association by 0.088 standard units; fMRI work distinguished neural reserve from neural compensation.
Methods
- Narrative review by the author, integrating his group’s and others’ epidemiologic cohort studies, functional and resting neuroimaging studies, postmortem analyses, and cognitive or exercise intervention trials.
- Cited samples include 593 non-demented adults aged 60 or older followed for 4 years, 130 elders who had cognitive evaluation before autopsy, and a preliminary 90-person older-adult Space Fortress training study.
- Main analysis is conceptual synthesis rather than a new primary study or formal meta-analysis; it draws on a cited systematic review of 22 cohort studies for one pooled estimate.
Limitations
- Stated: epidemiologic evidence is correlational and cannot establish causation; controlled intervention studies are needed, and no study to date has shown changes in the key endpoints of slowed cognitive decline or reduced Alzheimer’s disease risk.
- Stated: clinical use of biomarkers and imaging for reserve is premature because prognostic implications are not fully established, and cognitive training evidence is mixed.
- Evident from the text: this is a narrative review without formal risk-of-bias assessment, many findings come from the author’s own research program, and the interaction between brain reserve and cognitive reserve remains unresolved.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
39 Own interpretation · 14 No full text of the sources · 12 No basis given · 10 Supported · 10 Own result · 8 Partly supported · 5 Supported so far · 3 Not checked yet · 2 Couldn’t confirm · 1 Sources not found · accuracy not yet measured
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“This idea is supported by a set of studies that suggest that prevalence or incidence of dementia is lower in individuals with larger brains13, 14.”
§ Cognitive reserve in ageing and Alzheimer's disease > Cognitive and Brain Reserve
What the sources say
- Not checked — no full text of the sourcecites [13] Katzman, 1988, Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques, Ann Neurol source
- Supportedcites [14] Schofield, 1997, An association between head circumference and Alzheimer's disease in a population-based study of aging, Neurology source
The Discussion (p. 5) reports that smaller head circumference was associated with higher prevalence of Alzheimer’s disease. The paper uses head circumference as an index of premorbid brain size (p. 1), so its finding supports the citing sentence’s hedged association. This study measured prevalence of Alzheimer’s disease, not incidence of dementia generally. (LLM, conf=0.88)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Second, compared to individuals with lower CR, those with higher CR performed better even when they use the second network.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Neural Mechanisms Underlying CR
What the sources say
- Supportedcites [42] Steffener, 2011, Supporting performance in the face of age-related neural changes: testing mechanistic roles of cognitive reserve, Brain Imaging Behav source
The Results (Model C) report that, in older adults, higher cognitive reserve reduced the negative effect of network 2 expression on task performance. The Discussion likewise says older adults with greater reserve maintained performance better as network 2 expression increased. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Those who engaged in more leisure activities had 38% less risk of developing dementia.”
§ Cognitive reserve in ageing and Alzheimer's disease > Epidemiologic evidence for reserve
What the sources say
- Supportedcites [24] Scarmeas, 2001, Influence of leisure activity on the incidence of Alzheimer's disease, Neurology source
The Discussion explicitly states that subjects with high leisure activity had 38% less risk of developing dementia. The Results report a relative risk of 0.62 (95% CI 0.46–0.83), consistent with that figure. (LLM, conf=0.95)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The rate of decline is more rapid in individuals with high reserve than those with low reserve, even when accounting for a multitude of other factors that may contribute to disease course27, 28, 46.”
§ Cognitive reserve in ageing and Alzheimer's disease > Application Of Cognitive Reserve In Clinical Practice
What the sources say
- Supportedcites [27] Stern, 1999, Rate of memory decline in AD is related to education and occupation: cognitive reserve?, Neurology sourceExperimental — accuracy not yet measured
The DOI was not indexed for paper-scoped Semantic Scholar search, so the cited paper’s full text could not be checked directly. A systematic review, “Education and Dementia in the Context of the Cognitive Reserve Hypothesis” (search score 0.789), explicitly attributes more rapid memory decline in Alzheimer’s patients with higher education and occupational attainment to Stern et al. (1999). This supports the central claim, though the retrieved passage does not verify which other factors the original analysis accounted for. (LLM, conf=0.81)
- Supportedcites [28] Scarmeas, 2006, Education and rates of cognitive decline in incident Alzheimer's disease, J Neurol Neurosurg Psychiatry sourceExperimental — accuracy not yet measured
No paper-scoped Semantic Scholar snippets were available for Scarmeas et al. (2006). However, “Higher education affects accelerated cortical thinning in Alzheimer's disease” explicitly cites Scarmeas et al. (2006) among studies finding more rapid cognitive decline after Alzheimer’s onset in patients with higher education (snippet score 0.534). This supports the claim through a secondary citation, although the available evidence does not independently verify which other factors Scarmeas et al. adjusted for. (LLM, conf=0.76)
- Supportedcites [46] Hall, 2007, Education delays accelerated decline on a memory test in persons who develop dementia, Neurology sourceExperimental — accuracy not yet measured
Hall’s (2007) title establishes the finding of delayed accelerated memory decline in people who develop dementia. A Semantic Scholar snippet from “Episodic memory performance in a multi-ethnic longitudinal study of 13,037 elderly” describes the same pattern: education is associated with a delayed change point followed by faster decline (score 0.52). Hall’s full text was unavailable in the paper-scoped search, so the specific assertion about accounting for other factors could not be checked directly; the available evidence supports the core paraphrase, not every qualification. (LLM, conf=0.72)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In a young group of subjects we identified an activation network that was expressed during the stimulus presentation phase of both tasks and whose increase in expression with increasing load correlated with CR.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Neural Mechanisms Underlying CR
What the sources say
- Supportedcites [43] Stern, 2008, A common neural network for cognitive reserve in verbal and object working memory in young but not old, Cereb Cortex source
The Discussion identifies a pattern in young subjects during stimulus presentation whose load-related activation had a similar relationship with cognitive reserve in both the letter and shape tasks. The Canonical Variates Analysis reports significant expression of that pattern in both tasks and relates its load-related expression to cognitive-reserve scores. (LLM, conf=0.91)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Similar analysis demonstrated a comparable protective effect of occupational attainment33 and leisure activities34.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Scans Acquired at Rest
What the sources say
- Not checked — no full text of the sourcecites [33] Stern, 1995, Relationship between lifetime occupation and parietal flow: implications for a reserve against Alzheimer's disease pathology, Neurology source
- Supportedcites [34] Scarmeas, 2003, Association of life activities with cerebral blood flow in Alzheimer disease: implications for the cognitive reserve hypothesis, Arch Neurol source
The cited paper’s Results report an inverse association between activity scores and cerebral blood flow after controlling for clinical severity, which the authors interpret as consistent with cognitive reserve. The Conclusions describe analogous findings for occupational attainment and note evidence linking leisure activities to reduced dementia risk. The citation supports the leisure-activities part of the sentence; occupational attainment has a separate citation. (LLM, conf=0.85)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“For example, at a given level of clinical severity, AD patients with higher education have a more severe pattern of AD-related changes on PET scan than those with lower education44, 45.”
§ Cognitive reserve in ageing and Alzheimer's disease > Application Of Cognitive Reserve In Clinical Practice
What the sources say
- Not checked — no full text of the sourcecites [44] Garibotto, 2008, Education and occupation as proxies for reserve in aMCI converters and AD: FDG-PET evidence, Neurology source
- Supportedcites [45] Kemppainen, 2008, Cognitive reserve hypothesis: Pittsburgh Compound B and fluorodeoxyglucose positron emission tomography in relation to education in mild Alzheimer's disease, Ann Neurol source
The Abstract reports that high- and low-educated patients with mild Alzheimer’s disease had the same degree of cognitive deterioration, while the high-educated group showed greater amyloid-tracer uptake and lower glucose metabolism on PET. The Discussion likewise describes more pronounced amyloid accumulation and neuronal dysfunction in the high-educated group. (LLM, conf=0.93)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“In AD patients matched for clinical severity, we found an inverse relationship between resting rCBF and years of education32.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Scans Acquired at Rest
What the sources say
- Supportedcites [32] Stern, 1992, Inverse relationship between education and parietotemporal perfusion deficit in Alzheimer's disease, Ann Neurol source
The Procedures (p. 2) state that rCBF was measured under resting conditions. The Results (pp. 2–3) report greater parietotemporal flow reductions with more education in AD groups that did not differ on clinical measures; the relationship at the P3 detector remained significant after controlling for dementia severity. (LLM, conf=0.92)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The neural implementation of CR might take two forms: neural reserve and neural compensation16, 38.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Neural Mechanisms Underlying CR
What the sources say
- Supportedcites [16] Stern, 2009, Cognitive reserve, Neuropsychologia source
In “Neural Mechanisms Underlying CR,” Stern explicitly says that the neural implementation of cognitive reserve might take two forms: neural reserve and neural compensation. The “Brain Reserve and Cognitive Reserve” section also describes them as two proposed components. (LLM, conf=0.95)
- Supportedcites [38] Stern, 2005, Brain networks associated with cognitive reserve in healthy young and old adults, Cereb Cortex source
The Introduction (p. 1) explicitly proposes two complementary facets of the neural implementation of cognitive reserve: neural reserve and neural compensation. The paper then defines and contrasts them in the Introduction (pp. 1–2). (LLM, conf=0.95)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“These observations using cerebral blood flow have been replicated by other groups as well35, 36.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Scans Acquired at Rest
What the sources say
- Not checked — no full text of the sourcecites [35] Alexander, 1997, Association of premorbid intellectual function with cerebral metabolism in Alzheimer's disease: implications for the cognitive reserve hypothesis, Am J Psychiatry source
- Supportedcites [36] Perneczky, 2006, Schooling mediates brain reserve in Alzheimer's disease: findings of fluoro-deoxy-glucose-positron emission tomography, J Neurol Neurosurg Psychiatry source
The Results report an inverse association between schooling and glucose metabolism in patients with Alzheimer’s disease. The Discussion says these findings are supported by other groups’ cerebral-blood-flow studies, while noting that the results do not match exactly because of differences in samples and methods. This paper used FDG-PET rather than measuring cerebral blood flow itself. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 15
- It may state two separate claims as one. 17
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“In contrast, the concept of CR suggests that the brain actively attempts to cope with brain damage by using pre-existing cognitive processing approaches or by enlisting compensatory approaches15, 16.”
§ Cognitive reserve in ageing and Alzheimer's disease > Cognitive and Brain Reserve
What the sources say
- Not checked — no full text of the sourcecites [15] Stern, 2002, What is cognitive reserve? Theory and research application of the reserve concept, J Int Neuropsychol Soc source
- Supportedcites [16] Stern, 2009, Cognitive reserve, Neuropsychologia source
The “Brain Reserve and Cognitive Reserve” section states that active models such as CR propose that the brain copes with damage using pre-existing cognitive processes or enlisting compensatory processes. This directly supports the paraphrase; no page number is provided in our copy. (LLM, conf=0.95)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“We replicated this observation in patients with incident AD28 and also found more rapid decline in cognitive function in AD patients who engaged in more leisure activities prior to dementia onset29.”
§ Cognitive reserve in ageing and Alzheimer's disease > Epidemiologic evidence for reserve
What the sources say
- Partly supportedcites [28] Scarmeas, 2006, Education and rates of cognitive decline in incident Alzheimer's disease, J Neurol Neurosurg Psychiatry sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
- Supportedcites [29] Helzner, 2007, Leisure activity and cognitive decline in incident Alzheimer disease, Arch Neurol source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Using a covariance method to analyze the imaging data, we identified a spatial pattern of fMRI activation that was expressed by both groups and whose expression increased as the task became more difficult.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Neural Mechanisms Underlying CR
What the sources say
- Supportedcites [39] Stern, 2012, Task difficulty modulates young-old differences in network expression, Brain Res source
The Functional imaging section identifies a spatial pattern common to young and old participants. The Discussion states that its expression increased logarithmically with task difficulty. Page numbers are not provided in our copy. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In a follow-up analysis41, we found that atrophy in a key area within the first network (i.e. the one that was used by both young and old) was associated with decreased efficiency in that network and increased utilization of the second network.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Neural Mechanisms Underlying CR
What the sources say
- Partly supportedcites [41] Steffener, 2009, The impact of age-related changes on working memory functional activity, Brain Imaging Behav sourceExperimental — accuracy not yet measured
The Abstract and Conclusion report that lower grey-matter volume in a region of the primary network was associated with greater secondary-network recruitment. The Discussion interprets this as compensation for an affected primary network, but the Results report no significant association between regional grey-matter volume and primary-network expression; decreased efficiency of that network was not demonstrated. (LLM, conf=0.86)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“For example, Basak et al.50 had elders play a complex role-playing game,”
§ Cognitive reserve in ageing and Alzheimer's disease > Implications of Cognitive Reserve for Remediation and Prevention
What the sources say
- Partly supportedcites [50] Basak, 2008, Can training in a real-time strategy video game attenuate cognitive decline in older adults?, Psychol Aging sourceExperimental — accuracy not yet measured
The Method > Participants section says older adults were assigned to play Rise of Nations, and the General Discussion reports transfer benefits after 23.5 hours of training. The paper identifies Rise of Nations as a complex real-time strategy game, not a role-playing game. Its Abstract reports improvement on a subset of cognitive tasks, rather than across the entire battery (page numbers unavailable in our copy). (LLM, conf=0.90)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In research with young adults, one particular training approach produced excellent improvement in gameplay, but, more importantly, also showed transfer of training to other tasks.”
§ Cognitive reserve in ageing and Alzheimer's disease > Implications of Cognitive Reserve for Remediation and Prevention
What the sources say
- Not checked — no full text of the sourcecites [55] Gopher, 1994, Transfer of skill from a computer game trainer to flight, Hum Factors source
- Not checked — no full text of the sourcecites [56] Gopher, 1989, Practice under changing priorities: an approach to the training of complex skills, Acta Psychol source
- Partly supportedcites [57] Blumen, 2010, Training cognitive control in older adults with the space fortress game: the role of training instructions and basic motor ability, Front Aging Neurosci sourceExperimental — accuracy not yet measured
The Introduction (‘The space fortress game and emphasis change instructions’; page unavailable) reports that emphasis-change instructions improved Space Fortress performance in younger adults compared with standard instructions. It says those instructions *may* be important for transfer, but does not report that this approach demonstrated transfer to other tasks. The General Discussion (page unavailable) says future studies will determine whether such transfer occurs. (LLM, conf=0.86)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Those who rely more on this alternate network can still perform the task, but do so more poorly.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Neural Mechanisms Underlying CR
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On the average scores on a memory test decline by about one point yearly, but in those with higher educational or occupational attainment scores decline by an additional point each year.”
§ Cognitive reserve in ageing and Alzheimer's disease > Epidemiologic evidence for reserve
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The first network was used by both young and old subjects, and consisted of areas often associated with working memory.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Neural Mechanisms Underlying CR
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In contrast, the second network was primarily characterized by activation in parahippocampal areas and was used consistently only by the older subjects.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Neural Mechanisms Underlying CR
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Interestingly, although the game itself was very challenging for the elders, there were few dropouts and performance improved over time.”
§ Cognitive reserve in ageing and Alzheimer's disease > Implications of Cognitive Reserve for Remediation and Prevention
What the sources say
- Not checked — no full text of the sourcecites [58] Orrell, 1995, Education and dementia, BMJ source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Interestingly, although the game itself was very challenging for the elders, there were few dropouts and performance improved over time.”
§ Cognitive reserve in ageing and Alzheimer's disease > Implications of Cognitive Reserve for Remediation and Prevention
What the sources say
- Not checked — no full text of the sourcecites [58] Orrell, 1995, Education and dementia, BMJ source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Each of these networks is a group of brain areas that seem to work together as the task is harder.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Neural Mechanisms Underlying CR
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Given these assumptions, individuals with higher CR will begin their cognitive decline when pathology is more advanced and thus have less time until they reach the point where pathology overwhelms function.”
§ Cognitive reserve in ageing and Alzheimer's disease > Epidemiologic evidence for reserve
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: There is a common point in all people where pathology is so severe that function cannot be maintained.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Still, while in some ways interdependent, brain reserve and CR make independent in addition to synergistic contributions to understanding individual differences in clinical resilience to brain pathology.”
§ Cognitive reserve in ageing and Alzheimer's disease > Cognitive and Brain Reserve
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, the cognitive or neural mechanism that underlies this reserve is unknown.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Neural Mechanisms Underlying CR
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, clinicians must be aware that in the presence of pathology there should still be a period of time during which even the most sensitive measures would fail to detect cognitive change.”
§ Cognitive reserve in ageing and Alzheimer's disease > Application Of Cognitive Reserve In Clinical Practice
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Individuals with high reserve, by definition, will not demonstrate disease-related clinical symptoms as early as individuals with low levels of reserve.”
§ Cognitive reserve in ageing and Alzheimer's disease > Application Of Cognitive Reserve In Clinical Practice
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Since people with greater reserve should be able to tolerate more AD pathology, the onset of clinical dementia should be delayed.”
§ Cognitive reserve in ageing and Alzheimer's disease > Epidemiologic evidence for reserve
plaindirectn = 593- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is possible that individuals with more efficient or higher capacity networks could have more resilience in the face of age- or disease-related changes.”
§ Cognitive reserve in ageing and Alzheimer's disease > Neuroimaging Studies of Cognitive Reserve > Neural Mechanisms Underlying CR
hedgedconditional- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Only controlled studies can truly establish that some set of interventions or experiences are beneficial.”
§ Cognitive reserve in ageing and Alzheimer's disease > Epidemiologic evidence for reserve
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
In the paper
“In schizophrenia, small effects of cognitive remediation were noted, particularly in stable patients and when combined with adjunctive rehabilitation52.”
§ Cognitive reserve in ageing and Alzheimer's disease > Implications of Cognitive Reserve for Remediation and Prevention
What the sources say
- Not matchedcites [52]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Not matched
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In the paper
“While the original observations concern easily measurable variables like education or occupational attainment, more recent studies have delved more deeply into lifestyle factors, cognitively stimulating behaviors, personality factors and the like.”
§ Cognitive reserve in ageing and Alzheimer's disease > Conclusion
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“However, the exact”
§ Cognitive reserve in ageing and Alzheimer's disease > Implications of Cognitive Reserve for Remediation and Prevention
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These findings support the possibility that it may be possible to intervene even later in life in order to impart reserve, slow age-related cognitive decline, and prolonged healthy aging.”
§ Cognitive reserve in ageing and Alzheimer's disease > Implications of Cognitive Reserve for Remediation and Prevention
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This is a hopeful idea, since it suggests that changes in lifestyle even later in life might impart reserve against age-related cognitive decline or dementia.”
§ Cognitive reserve in ageing and Alzheimer's disease > Conclusion
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
In the paper
“Similarly, focused training has improved working memory capacity and shown transfer of training to nontrained working memory tasks51.”
§ Cognitive reserve in ageing and Alzheimer's disease > Implications of Cognitive Reserve for Remediation and Prevention
What the sources say
- Not checked — no full text of the sourcecites [51] Klingberg, 2010, Training and plasticity of working memory, Trends Cogn Sci source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Studies using these endpoints will be very expensive because they will require a large number of participants and will have to be conducted over several years.”
§ Cognitive reserve in ageing and Alzheimer's disease > Implications of Cognitive Reserve for Remediation and Prevention
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“While epidemiologic studies can only describe correlations and do not directly test causation, they are useful for deriving hypotheses and exploring ideas.”
§ Cognitive reserve in ageing and Alzheimer's disease > Conclusion
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By shifting emphasis from game to game, participants cannot fall into a fixed strategy. They must develop the ability to deal with the entire task as a whole – skills that might be termed attentional allocation or executive control.”
§ Cognitive reserve in ageing and Alzheimer's disease > Implications of Cognitive Reserve for Remediation and Prevention
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The authors state this as an assumption.
Disease pathology slowly develops over time independently of cognitive reserve, and pathology begins many years before the onset of clinically diagnosed Alzheimer's disease.
“The assumption is that disease pathology slowly develops over time independently of CR, and that the pathology begins many years before the onset of clinically diagnosed AD.”
The authors state this as an assumption.
There is a common point in all people where pathology is so severe that function cannot be maintained.
“However, we reasoned that there is common point in all people where the pathology is so severe that function cannot be maintained.”
The paper relies on this without support.
No study to date has shown change in slowed rate of cognitive decline in aging or reduced risk of developing Alzheimer's disease.
“No study to date has shown change in either of these endpoints.”
The paper relies on this without support.
The brain both passively and actively attempts to cope with brain changes or pathology.
“Since the brain both passively and actively attempts to cope with brain changes or pathology, it is important to understand the factors that contribute to this resilience.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“Researchers have long reported that people with more years of formal education are at lower risk for Alzheimer's and other dementias than those with fewer years of formal education.80,[144][145][146][147][148][149]”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [146]
The cited source says what the claim attributes to it.
In the citing paper
“This concept was theoretically framed by Park and Bischof (2013) as “scaffolding,” similar to the closely related cognitive reserve theory proposed by Stern (2012).”
In the citing paper
“supporting the theory that a greater cognitive reserve could help protect against development of LOAD117.”
From Genetic meta-analysis of diagnosed Alzheimer’s disease identifies new risk loci and implicates Aβ, tau, immunity and lipid processing (2019) · cites this paper as [117]
In the citing paper
“The level of education, a surrogate marker of cognitive reserves (Stern, 2012), is an important determinant of the expression of VCI, such that for a given level of neuropathology higher education is associated with less cognitive deficits (Zieren et al., 2013).”
From The Pathobiology of Vascular Dementia (2013) · cites this paper as Stern, 2012
In the citing paper
“These findings lead to the suggestion that higher social engagement and support experienced both before and during lockdown due to the COVID-19 pandemic might have had a protective/mitigating role by contributing to cognitive (51) and affective reserve (52).”
From The impact of COVID-19 infection and enforced prolonged social isolation on neuropsychiatric symptoms in older adults with and without dementia: A review (2020) · cites this paper as [51]
In the citing paper
“Cognitive reserve theory suggests that individuals differ in their level of resilience against brain pathology and hence may exhibit differences in cognitive function despite equivalent levels of pathology (Stern, 2002(Stern, , 2012)).”
From Living alone and cognitive function in later life (2019) · cites this paper as Stern, 2012
In the citing paper
“The theory suggests that individuals differ in their degree of resilience against age-related brain pathology and hence may show differences in cognitive function in relation to an equivalent level of pathology [8, 9].”
From Social isolation, cognitive reserve, and cognition in healthy older people (2018) · cites this paper as [9]
In the citing paper
“Cognitive reserve is a theoretical concept that may account for the role of social isolation and its association with cognitive outcomes in later life.”
From Social isolation, cognitive reserve, and cognition in healthy older people (2018) · cites this paper as [9]
In the citing paper
“Such individuals are likely to receive less cognitive stimulation through social contact, resulting in lower cognitive reserve and hence poorer cognitive function [8, 9].”
From Social isolation, cognitive reserve, and cognition in healthy older people (2018) · cites this paper as [9]
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“Some researchers believe that having more years of education builds a “cognitive reserve” that enables individuals to better compensate for changes in the brain that could result in symptoms of Alzheimer’s or another dementia [76,78,79].”
Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria
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“All these scenarios have been empirically observed (see, e.g., Stern, 2006, 2009, 2012, for reviews) and can be explained without evoking the concept of cognitive reserve.”
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“Another interpretation could be found in the concept of “cerebral reserves” (Stern, 2002, 2012) a mechanisms that might explain why, in the face of neurodegenerative changes that are similar in nature and extent, individuals vary considerably in the severity of cognitive aging and clinical dementia…”
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“high cognitive reserve would be less likely to display the cognitive symptoms associated with dementia compared to individuals with the same pathology and low cognitive reserve.(131,132)”
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“Our results indicated amoderator effect of educational attainment,which is often used as a proxy for cognitive reserve.(76) Increasingevidence suggests thatARHL is associatedwith a wide range of health issues, higher disease burden, and increased risk for hospitalization,(64,77) leading to greater awareness of this co…”
MethodHow Does it STAC Up? Revisiting the Scaffolding Theory of Aging and Cognition
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“It follows from this example that high ability or highly educated older adults with normal cognitive function could harbor greater neural degradation than their less educated counterparts (Stern 2012, 2002).”
BackgroundMethodInfluentialCausal associations between risk factors and common diseases inferred from GWAS summary data
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“Education is an often-used proxy for cognitive reserve, which is defined as the ability to maintain cognitive function despite high levels of AD pathology (Stern et al., 1999; Stern, 2006, 2012).”
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BackgroundThe effects of aging in the hippocampus and cognitive decline
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“Thus, exposure to a multitude of life experiences that can potentially stimulate brain plasticity (by increasing the number of neurons and synapses, decreasing apoptosis, and up-regulating neurotrophic support) may have a protective effect against various neuropathologies (Stern, 2012, 2009).”
Implementation of subjective cognitive decline criteria in research studies
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“These lifestyle characteristics influence “cognitive reserve” and onset of objective cognitive decline [18].”
BackgroundState of the science on mild cognitive impairment (MCI)
Anderson, N. D. (2019) · CNS Spectrums · doi:10.1017/s1092852918001347 · Cited by 587
Gender and incidence of dementia in the Framingham Heart Study from mid‐adult life
Chêne, G., Beiser, A., Au, R., Preis, S. R., Wolf, P. A., Dufouil, C., & Seshadri, S. (2015) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2013.10.005 · Cited by 499
“As far as the cognitive reserve concept is concerned, the original hypothesis is based on the assumptions that (1) a higher cognitive reserve does contribute to delayed onset of dementia or AD and (2) that on average men have a higher cognitive reserve than women [28].”
BackgroundClinical and imaging assessment of cognitive dysfunction in multiple sclerosis
Rocca, M. A., Amato, M. P., De Stefano, N., Enzinger, C., Geurts, J. J., Penner, I.-K., Rovira, A., Sumowski, J. F., Valsasina, P., & Filippi, M. (2015) · The Lancet Neurology · doi:10.1016/s1474-4422(14)70250-9 · Cited by 557
Inconsistencies and Controversies Surrounding the Amyloid Hypothesis of Alzheimer's Disease
Morris, G. P., Clark, I. A., & Vissel, B. (2014) · Acta Neuropathologica Communications · doi:10.1186/s40478-014-0135-5 · Cited by 522
“Some individuals may have a ‘cognitive reserve’, a hypothetical concept described as accumulating over a lifespan, allowing them to cope with more amyloid [94].”
BackgroundThe aging mind: neuroplasticity in response to cognitive training
Park, D. C., & Bischof, G. N. (2013) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2013.15.1/dpark · Cited by 508
The Locus Coeruleus: Essential for Maintaining Cognitive Function and the Aging Brain
Mather, M., & Harley, C. W. (2016) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2016.01.001 · Cited by 517
“It has long been observed that factors such as social engagement and education seem to protect against cognitive impairment even when Alzheimer’s disease neuropathology is present in the brain [7].”
Valian, V. V. (2014) · Bilingualism Language and Cognition · doi:10.1017/s1366728914000522 · Cited by 514
“…decline more rapidly than individuals with less education and lower occupational levels and they die sooner (Amieva, Mokri, Le Goff, Meillon, JacqminGadda, Foubert-Samier, Orgogozo, Stern & Dartigues, 2014; Stern, 2012, but see Zahodne, Glymour, Sparks, Bontempo, Dixon, MacDonald & Manly, 2011).”
Background2025 Alzheimer's disease facts and figures
(2025) · Alzheimer s & Dementia · doi:10.1002/alz.70235 · Cited by 642
Smoking and increased Alzheimer's disease risk: A review of potential mechanisms
Durazzo, T. C., Mattsson, N., Weiner, M. W., & Initiative, A. D. N. (2014) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2014.04.009 · Cited by 501
“…midlife smoking and risk for AD may also be influenced by potential differences between smokers and nonsmokers on brain reserve, cognitive reserve [238], and other unrecognized ge-netic and/or premorbid/comorbid factors, as well as other modifiable factors such as diet, physical activity, and…”
Anderson, N. D., The BRAVO Team, Damianakis, T., Kröger, E., Wagner, L. M., Dawson, D. R., Binns, M. A., Bernstein, S., Caspi, E., & Cook, S. L. (2014) · Psychological Bulletin · doi:10.1037/a0037610 · Cited by 481
Microglia modulate neurodegeneration in Alzheimer’s and Parkinson’s diseases
Bartels, T., De Schepper, S., & Hong, S. (2020) · Science · doi:10.1126/science.abb8587 · Cited by 412
Anxiety as a Predictor for Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis
Gulpers, B., Ramakers, I., Hamel, R., Köhler, S., Oude Voshaar, R., & Verhey, F. (2016) · The American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2016.05.015 · Cited by 409
“[44] Anxiety disorders often have an enduring course throughout life and are frequently accompanied with avoidance behavior.”
BackgroundSink, K. M., Espeland, M. A., Castro, C. M., Church, T., Cohen, R., Dodson, J. A., Guralnik, J., Hendrie, H. C., Jennings, J., Katula, J., et al. (2015) · JAMA · doi:10.1001/jama.2015.9617 · Cited by 402
Cognitive Reserve and the Prevention of Dementia: the Role of Physical and Cognitive Activities
Cheng, S.-T. (2016) · Current Psychiatry Reports · doi:10.1007/s11920-016-0721-2 · Cited by 385
Injured Brains and Adaptive Networks: The Benefits and Costs of Hyperconnectivity
Hillary, F. G., & Grafman, J. H. (2017) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2017.03.003 · Cited by 388
How Can Hearing Loss Cause Dementia?
Griffiths, T. D., Lad, M., Kumar, S., Holmes, E., McMurray, B., Maguire, E. A., Billig, A. J., & Sedley, W. (2020) · Neuron · doi:10.1016/j.neuron.2020.08.003 · Cited by 389
“Based on animal models, it has been proposed (Nithianantharajah and Hannan, 2009; Sale et al., 2014) that such changesmay establish cognitive reserve, which is argued to protect against dementia in humans (Stern, 2012).”
Relationship of Hearing Loss and Dementia
Gurgel, R. K., Ward, P. D., Schwartz, S., Norton, M. C., Foster, N. L., & Tschanz, J. T. (2014) · Otology & Neurotology · doi:10.1097/mao.0000000000000313 · Cited by 385
“Education level was kept in the models because it is a known risk factor for dementia (31).”
BackgroundEmpirical evidence for discrete neurocognitive subgroups in bipolar disorder: clinical implications
Burdick, K. E., Russo, M., Frangou, S., Mahon, K., Braga, R. J., Shanahan, M. R., & Malhotra, A. K. (2014) · Psychological Medicine · doi:10.1017/s0033291714000439 · Cited by 355
“This is consistent with mild pre-morbid deficits seen in patients with schizophrenia (Woodberry et al. 2008) and could be conceptualized in reference to the cognitive reserve theory, where higher cognitive capacity could serve as protective against decline (Stern, 2012).”
BackgroundResultDietary and lifestyle guidelines for the prevention of Alzheimer's disease
Barnard, N. D., Bush, A. I., Ceccarelli, A., Cooper, J. K., de Jager, C. A., Erickson, K. I., Fraser, G. E., Kesler, S. R., Levin, S., Lucey, B. P., et al. (2014) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2014.03.033 · Cited by 340
Alzheimer’s Disease: An Updated Overview of Its Genetics
Andrade-Guerrero, J., Santiago-Balmaseda, A., Jeronimo-Aguilar, P., Vargas-Rodríguez, I., Cadena-Suárez, A. R., Sánchez-Garibay, C., Pozo-Molina, G., Méndez-Catalá, C. F., Cardenas-Aguayo, M.-D.-C., Diaz-Cintra, S., et al. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24043754 · Cited by 336
Phillips, C. (2017) · Neural Plasticity · doi:10.1155/2017/3589271 · Cited by 370
Advances in the prevention of Alzheimer's disease and dementia
Solomon, A., Mangialasche, F., Richard, E., Andrieu, S., Bennett, D., Breteler, M. M. B., Fratiglioni, L., Hooshmand, B., Khachaturian, A. S., Schneider, L. S. S., et al. (2014) · Journal of Internal Medicine · doi:10.1111/joim.12178 · Cited by 330
Jeremic, D., Jiménez-Díaz, L., & Navarro-López, J. D. (2021) · Ageing Research Reviews · doi:10.1016/j.arr.2021.101496 · Cited by 306
“Some studies suggest that high educational level, social and mental activities are associated with lower risk of Alzheimer’s, due to the improved cognitive reserve, which seems to contribute to the difference in symptoms among patients (Delpak and Talebi, 2020; Stern, 2012).”
Assessing the mechanisms of brain plasticity by transcranial magnetic stimulation
Jannati, A., Oberman, L. M., Rotenberg, A., & Pascual‐Leone, Á. (2022) · Neuropsychopharmacology · doi:10.1038/s41386-022-01453-8 · Cited by 326
“These results suggest that iTBS measures of plasticity as measured by changes in rsFC can provide an index of the brain’s resilience in aging and enable the assessment of network plasticity, which may constitute a neurophysiological substrate of cognitive reserve [177, 178].”
BackgroundMarden, J. R., Tchetgen Tchetgen, E. J., Kawachi, I., & Glymour, M. M. (2017) · American Journal of Epidemiology · doi:10.1093/aje/kwx155 · Cited by 284
Exercise, cognitive function, and aging
Barnes, J. N. (2015) · AJP Advances in Physiology Education · doi:10.1152/advan.00101.2014 · Cited by 314
“However, not all individuals with significant amyloid deposition develop AD (42, 48).”
BackgroundSherman, D. S., Mauser, J., Nuno, M. A., & Sherzai, D. (2017) · Neuropsychology Review · doi:10.1007/s11065-017-9363-3 · Cited by 301
“In addition, cognitively stimulating activities may aid in engaging cognitive reserves to slow decline or reduce the risk of greater pathology (Ciarmiello et al. 2015; De Marco et al. 2016; Herholz et al. 2013; Stern 2012).”
BackgroundHerold, F., Hamacher, D., Schega, L., & Müller, N. G. (2018) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2018.00228 · Cited by 316
“…2016) that serve to enhance the cognitive reserve [defined as individual differences in how people process tasks; detailed description of term and concept could be found in Stern (2002, 2009)] and the resilience against neurodegeneration (Nithianantharajah and Hannan, 2009; Stern, 2012, 2013).”
BackgroundCognitive correlates in amyotrophic lateral sclerosis: a population-based study in Italy
Montuschi, A., Iazzolino, B., Calvo, A., Moglia, C., Lopiano, L., Restagno, G., Brunetti, M., Ossola, I., Presti, A. L., Cammarosano, S., et al. (2014) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2013-307223 · Cited by 282
Healthy ageing, resilience and wellbeing
Cosco, T. D., Howse, K., & Brayne, C. (2017) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796017000324 · Cited by 321
“…model, it is suggested that individuals who engage in activities that build up their cognitive faculties, for example through advanced education (Stern, 2007, 2012), can accommodate physiological insults, e.g., plaques and tangles, which are often present in individuals with dementia (Brayne et…”
BackgroundPrevention of diseases after menopause
Løbo, R. A., Davis, S. R., de Villiers, T. J., Gompel, A., Henderson, V. W., Hodis, H. N., Lumsden, M.-A., Mack, W. J., Shapiro, S., & Baber, R. (2014) · Climacteric · doi:10.3109/13697137.2014.933411 · Cited by 282
Govindpani, K., McNamara, L. G., Smith, N. R., Vinnakota, C., Waldvogel, H. J., Faull, R. L. M., & Kwakowsky, A. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8050651 · Cited by 281
“Cognitive reserve may result in the preservation of cognitive function until a critical mass of neuronal loss has been achieved [101].”
BackgroundRacial and ethnic differences in trends in dementia prevalence and risk factors in the United States
Chen, C., & Zissimopoulos, J. (2018) · Alzheimer s & Dementia Translational Research & Clinical Interventions · doi:10.1016/j.trci.2018.08.009 · Cited by 278
“Prior studies also found that higher education was associated with better cognitive function consistent with the cognitive reserve hypothesis that links education with better tolerance of age-related brain changes and thus function [42,43].”
ResultNeighborhood Environment and Cognition in Older Adults: A Systematic Review
Besser, L. M., McDonald, N., Song, Y., Kukull, W. A., & Rodrı́guez, D. A. (2017) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2017.02.013 · Cited by 273
“Lower NSES was associated with worse cognition after controlling for personal SES, a strong predictor of mortality and AD risk.(55,56) NSES has been associated with multiple health outcomes and may be independently associated with cognition by affecting an individual’s social interactions and level of social isolation…”
BackgroundZahodne, L. B., Stern, Y., & Manly, J. J. (2014) · Neuropsychology · doi:10.1037/neu0000141 · Cited by 267
“…only in the low-education group because significantly more individuals in that group were diagnosed with dementia during this study period, in line with substantial research showing that lower educational attainment is a consistently strong predictor of earlier dementia diagnosis (Stern, 2012).”
ResultSelf-citationThe impact of bilingualism on brain reserve and metabolic connectivity in Alzheimer's dementia
Perani, D., Farsad, M., Ballarini, T., Lubian, F., Malpetti, M., Fracchetti, A., Magnani, G., March, A., & Abutalebi, J. (2017) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1610909114 · Cited by 266
“Education and occupation are indeed among the main sources and proxies of CR (1), and our bilingual subjects could be expected to be at a disadvantage in terms of CR (1).”
BackgroundMarriage and risk of dementia: systematic review and meta-analysis of observational studies
Sommerlad, A., Ruegger, J., Singh-Manoux, A., Lewis, G., & Livingston, G. (2018) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp-2017-316274 · Cited by 252
Optimal cutoffs for the Montreal Cognitive Assessment vary by race and ethnicity
Milani, S. A., Marsiske, M., Cottler, L. B., Chen, X., & Striley, C. W. (2018) · Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring · doi:10.1016/j.dadm.2018.09.003 · Cited by 288
Age-related hearing impairment—a risk factor and frailty marker for dementia and AD
Panza, F., Solfrizzi, V., & Logroscino, G. (2015) · Nature Reviews Neurology · doi:10.1038/nrneurol.2015.12 · Cited by 259
Alzheimer’s pathogenic mechanisms and underlying sex difference
Zhu, D., Montagne, A., & Zhao, Z. (2021) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-021-03830-w · Cited by 275
Modifiable lifestyle factors and cognitive reserve: a systematic review of current evidence
Song, S., Stern, Y., & Gu, Y. (2022) · Ageing Research Reviews · doi:10.1016/j.arr.2021.101551 · Cited by 248
Self-citationHuijbers, W., Mormino, E. C., Schultz, A. P., Wigman, S. E., Ward, A. M., Larvie, M., Amariglio, R. E., Marshall, G. A., Rentz, D. M., Johnson, K. A., et al. (2015) · Brain · doi:10.1093/brain/awv007 · Cited by 254
Delgado-Saborit, J. M., Guercio, V., Gowers, A. M., Shaddick, G., Fox, N. C., & Love, S. (2020) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2020.143734 · Cited by 260
“…et al., 2012), ETS exposure (Ranft et al., 2009; Schikowski et al., 2015), alcohol consumption (Chen and Schwartz, 2009; Power et al., 2011; Sun and Gu, 2008; Weuve et al., 2012) and for indoor sources of pollution (Chen and Schwartz, 2009; Ranft et al., 2009) in their analyses still reported…”
BackgroundResultInfluentialCadar, D., Lassale, C., Davies, H., Llewellyn, D. J., Batty, G. D., & Steptoe, A. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.1012 · Cited by 245
“These findings are consistent with the cognitive reserve hypothesis, which acknowledges a rapid cognitive deterioration for people with highereducationonce thepathologicalprocessassociatedwith dementiahasbeen initiated.(7)However, findings fromtheSeoul DementiaManagement Project(15) showed therewere no additiveor syne…”
BackgroundResultCognitive decline in older adults with a history of traumatic brain injury
Moretti, L., Cristofori, I., Weaver, S. M., Chau, A., Tremont, J. N. P., & Grafman, J. H. (2012) · The Lancet Neurology · doi:10.1016/s1474-4422(12)70226-0 · Cited by 252
Hannan, A. J. (2014) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12102 · Cited by 240
Novel genetic loci underlying human intracranial volume identified through genome-wide association
Adams, H. H. H., Hibar, D. P., Chouraki, V. A., Stein, J. L., Nyquist, P., Rentería, M. E., Trompet, S., Vásquez, A. A., Seshadri, S. S., Desrivières, S., et al. (2016) · Nature Neuroscience · doi:10.1038/nn.4398 · Cited by 221
Age-related hearing loss and tinnitus, dementia risk, and auditory amplification outcomes
Jafari, Z., Kolb, B. E., & Mohajerani, M. H. (2019) · Ageing Research Reviews · doi:10.1016/j.arr.2019.100963 · Cited by 253
Kocahan, S., & Doğan, Z. (2017) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2017.15.1.1 · Cited by 249
Targeting the Synapse in Alzheimer’s Disease
Jackson, J., Jambrina, E., Li, J., Marston, H., Menzies, F., Phillips, K., & Gilmour, G. (2019) · Frontiers in Neuroscience · doi:10.3389/fnins.2019.00735 · Cited by 215
“The period for which the brain can engage compensatory mechanisms and remain resilient to injury may depend to a significant degree on its pre-injury state; the so-called theory of “cognitive reserve” (Stern, 2012).”
BackgroundDewanjee, S., Chakraborty, P., Bhattacharya, H., Chacko, L., Singh, B., Chaudhary, A., Javvaji, K., Pradhan, S. R., Vallamkondu, J., Dey, A., et al. (2022) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2022.09.032 · Cited by 243
Social isolation, cognitive reserve, and cognition in healthy older people
Evans, I. E. M., Llewellyn, D. J., Matthews, F. E., Woods, R. T., Brayne, C., Clare, L., & on behalf of the CFAS-Wales research team (2018) · PLOS ONE · doi:10.1371/journal.pone.0201008 · Cited by 227
Manca, R., De Marco, M., & Venneri, A. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.585540 · Cited by 227
“These findings lead to the suggestion that higher social engagement and support experienced both before and during lockdown due to the COVID-19 pandemic might have had a protective/mitigating role by contributing to cognitive (51) and affective reserve (52).”
BackgroundMaintaining older brain functionality: A targeted review
Ballesteros, S., Kraft, E., Santana, S., & Tziraki, C. (2015) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2015.06.008 · Cited by 250
“In summary , there are similarities between certain aspects of the cognitive and brain reserve theory ( Barulli and Stern , 2013 ; Stern , 2002 , 2009 , 2012 ) and the STAC - r theory .”
BackgroundNeurodevelopmental origin of cognitive impairment in schizophrenia
Bora, E. (2014) · Psychological Medicine · doi:10.1017/s0033291714001263 · Cited by 222
Ismail, Z., Gatchel, J., Bateman, D. R., Barcelos-Ferreira, R., Cantillon, M., Jaeger, J., Donovan, N. J., Mortby, M. E., & Mortby, M. E. (2018) · International Psychogeriatrics · doi:10.1017/s1041610217001880 · Cited by 221
“Finally, it has been proposed that chronic and recurrent anxiety disorders throughout the life-course may lead to avoidance behaviors, which in turn may result in lowered cognitive reserve as a result of less mental and social stimulation, therefore increasing the risk of dementia (Stern, 2012).”
BackgroundMorris, G. P., Clark, I. A., & Vissel, B. (2018) · Acta Neuropathologica · doi:10.1007/s00401-018-1918-8 · Cited by 212
“Indeed, the hypothetical concepts of ‘brain reserve’ and ‘cognitive reserve’ may have merit [257].”
BackgroundCoelho‐Júnior, H. J., Trichopoulou, A., & Panza, F. (2021) · Ageing Research Reviews · doi:10.1016/j.arr.2021.101395 · Cited by 227
Predicting cognitive decline in multiple sclerosis: a 5-year follow-up study
Eijlers, A. J. C., van Geest, Q., Dekker, I., Steenwijk, M. D., Meijer, K. A., Hulst, H. E., Barkhof, F., Uitdehaag, B. M. J., Schoonheim, M. M., & Geurts, J. J. G. (2018) · Brain · doi:10.1093/brain/awy202 · Cited by 222
Metadata
- Authors
- Stern, Y.
- Affiliations
- Columbia University Irving Medical Center (US)
- Corresponding author
- Stern, Yaakov
- ORCID
- Stern, Yaakov
- Venue
- The Lancet Neurology
- Publisher
- Elsevier BV
- Published
- 2012-11
- Volume
- 11
- Issue
- 11
- Pages
- 1006-1012
- ISSN
- 1474-4422 (ISSN-L)
- PMC
- PMC3507991
- OpenAlex
- W2144907160
- Cited by
- 3,557
- References
- 59
- Citations by year
- 2026: 412 · 2025: 352 · 2024: 311 · 2023: 343 · 2022: 281 · 2021: 303 · 2020: 350 · 2019: 292 · 2018: 244 · 2017: 213 · 2016: 176 · 2015: 125 · 2014: 93 · 2013: 58 · 2012: 1
- FWCI
- 12.06
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- The Lancet Neurology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- National Institute on Aging (R01AG026158, R01AG014671)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- cognitive reserve, brain reserve, Alzheimer's disease, cognitive aging, dementia risk, educational attainment, occupational attainment, leisure
- MeSH terms
- Aging, Alzheimer Disease, Animals, Humans, Cognitive Reserve
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