THE COGNITIVE RESERVE HYPOTHESIS: HOW ACTIVE LIFESTYLES MAY PREVENT COGNITIVE DECLINE

James F. Sumowski, Ph.D.
Research Scientist, Kessler Foundation Research Center,
Assistant Professor of Physical Medicine & Rehabilitation
University of Medicine & Dentistry of New Jersey, Newark, NJ, USA

There is an incomplete relationship between brain disease severity (i.e., neuropathological burden) and cognitive status in persons with neurologic disease. For instance, elders without dementia can meet the neuropathologic criteria for Alzheimer’s disease (AD) on autopsy, and persons with multiple sclerosis (MS) often withstand substantial brain atrophy without suffering cognitive impairment. To explain this disconnect, the cognitive reserve (CR) hypothesis states that higher lifetime intellectual enrichment reduces the negative impact of neuropathology on cognitive status. As such, persons with enriching lifestyles withstand larger neuropathological burdens before (or without) suffering cognitive impairment / dementia. This course will review neuropsychological and neuroimaging evidence for the CR hypothesis in AD, MS, stroke, and other neurologic diseases. We will also discuss modifiable lifestyle factors that contribute to CR, including cognitive leisure, aerobic exercise, and diet. As a result of participation in this course, the learner will achieve the following objectives: (1) acquire an understanding of the CR hypothesis, and how it is supported by neuropsychological and neuroimaging research, (2) understand how the CR hypothesis helps to explain the incomplete relationship between neuropathologic burden and cognitive status, and (3) be familiar with modifiable lifestyle factors that contribute to CR, thereby preventing / delaying cognitive decline.