Cognitive reserve, cortical plasticity and resistance to Alzheimer's disease
Open accessAbstract
There are aspects of the ageing brain and cognition that remain poorly understood despite intensive efforts to understand how they are related. Cognitive reserve is the concept that has been developed to explain how it is that some elderly people with extensive neuropathology associated with dementia show little in the way of cognitive decline. Cognitive reserve is intimately related to cortical plasticity but this also, as it relates to ageing, remains poorly understood at the present time. Despite the shortcomings in understanding, we do have some knowledge on which to base efforts to minimise the likelihood of an elderly person developing dementia. For some risks the evidence is far from secure, but resistance to Alzheimer's disease (AD) appears from epidemiological studies to be contributed to by avoiding hypertension in middle life, obesity, depression, smoking and diabetes and head injury and by undertaking extended years of education, physical exercise, and social and intellectual pursuits in middle and late life. Nutritional factors may also promote healthy brain ageing. Resistance to AD is also contributed to by genetic factors, particularly apolipoprotein E2, but some combinations of other genetic polymorphisms as well. Although multiple factors and possible interventions may influence cognitive reserve and susceptibility to dementia, much more work is required on the mechanisms of action in order to determine which, if any, may improve the clinical and epidemiological picture. Understanding of how such factors operate may lead to new initiatives to keep the elderly population in the 21st century able to lead active and fulfilling lives.
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As many as one-third of older adults who meet full neuropathological criteria for ADRD show no substantial cognitive impairment.
“Up to one-third of older adults meeting full neuropathological criteria for ADRD exhibit no significant cognitive impairment, suggesting that even relatively advanced neurodegeneration may be masked (or moderated) by compensatory processes, including social enrichment.29–31”
From Why the cognitive ‘fountain of youth’ may be upstream: pathways to dementia risk and resilience through social connectedness (2022) · cites this paper as [29]
Compensatory processes, including social enrichment, may mask or moderate even fairly advanced neurodegeneration.
“suggesting that even relatively advanced neurodegeneration may be masked (or moderated) by compensatory processes, including social enrichment.29–31”
From Why the cognitive ‘fountain of youth’ may be upstream: pathways to dementia risk and resilience through social connectedness (2022) · cites this paper as [29]
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- Authors
- Esiri, M. M., & Chance, S. A.
- Affiliations
- University of Oxford (GB)
- Corresponding author
- Esiri, Margaret M
- Venue
- Alzheimer's Research & Therapy
- Published
- 2012
- Volume
- 4
- Issue
- 2
- Pages
- 7
- ISSN
- 1758-9193 (ISSN-L)
- PMC
- PMC3334540
- OpenAlex
- W2166184830
- Cited by
- 95
- References
- 77
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 6 · 2023: 8 · 2022: 7 · 2021: 7 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 9 · 2016: 8 · 2015: 11 · 2014: 4 · 2013: 10 · 2012: 2
- FWCI
- 6.17
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Alzheimer s Research & Therapy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Autism Speaks
- National Institute for Health and Care Research
- University of Oxford
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Keywords
- cognitive reserve, cortical plasticity, dementia, brain aging, cognitive decline, risk factors, apolipoprotein E, genetic polymorphism, lifestyle intervention, physical activity, social engagement, dietary factors, hypertension, obesity, depression, diabetes mellitus, traumatic brain injury
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