Background: The capacity to mitigate dementia symptomology despite the prevailing brain pathology has been attributed to cognitive reserve. Objectives: This study aimed to investigate how psychometric performance differs between individuals with a high school versus college education (surrogate measures for medium and high cognitive reserves) given the same level of brain pathology assessed using quantitative structural MRI. Methods: We used data from the Aging Brain: Vasculature, Ischemia, and Behavior Study (ABVIB). Cognition was assessed using a neuropsychological battery that included those contained in the National Alzheimer’s Coordinating Center (NACC) uniform data set. Participants with a medium and high cognitive reserve were matched by level of structural MRI changes, gender, and age. Results: Matched-pair regression analyses indicated that individuals with a higher education had a significantly better performance in recognition and verbal fluency animals, working memory, and processing speed in complex tasks. Moreover, they had a better performance in interference trails compared to individuals with a high school education (medium cognitive reserve). Conclusions: Our findings suggest that, given the same level of brain pathology, individuals with a higher education (cognitive reserve) benefit from a superior performance in semantic memory and executive functioning. Differences in these cognitive domains may be key pathways explaining how individuals with a high cognitive reserve are able to diminish dementia symptomatology despite physical changes in the brain.

1.
Stern
Y
.
What is cognitive reserve? Theory and research application of the reserve concept
.
J Int Neuropsychol Soc
.
2002
Mar
;
8
(
3
):
448
60
.
[PubMed]
1355-6177
2.
Valenzuela
MJ
,
Sachdev
P
.
Brain reserve and dementia: a systematic review
.
Psychol Med
.
2006
Apr
;
36
(
4
):
441
54
.
[PubMed]
0033-2917
3.
Yates
LA
,
Ziser
S
,
Spector
A
,
Orrell
M
.
Cognitive leisure activities and future risk of cognitive impairment and dementia: systematic review and meta-analysis
.
Int Psychogeriatr
.
2016
Nov
;
28
(
11
):
1791
806
.
[PubMed]
1041-6102
4.
Morbelli
S
,
Nobili
F
.
Cognitive reserve and clinical expression of Alzheimer’s disease: evidence and implications for brain PET imaging
.
Am J Nucl Med Mol Imaging
.
2014
Apr
;
4
(
3
):
239
47
.
[PubMed]
2160-8407
5.
Almeida
RP
,
Schultz
SA
,
Austin
BP
,
Boots
EA
,
Dowling
NM
,
Gleason
CE
, et al
Effect of Cognitive Reserve on Age-Related Changes in Cerebrospinal Fluid Biomarkers of Alzheimer Disease
.
JAMA Neurol
.
2015
Jun
;
72
(
6
):
699
706
.
[PubMed]
2168-6149
6.
Bennett
DA
,
Schneider
JA
,
Wilson
RS
,
Bienias
JL
,
Arnold
SE
.
Education modifies the association of amyloid but not tangles with cognitive function
.
Neurology
.
2005
Sep
;
65
(
6
):
953
5
.
[PubMed]
0028-3878
7.
Franzmeier
N
,
Caballero
,
Taylor
AN
,
Simon-Vermot
L
,
Buerger
K
,
Ertl-Wagner
B
, et al;
Alzheimer’s Disease Neuroimaging Initiative
.
Resting-state global functional connectivity as a biomarker of cognitive reserve in mild cognitive impairment
.
Brain Imaging Behav
.
2017
Apr
;
11
(
2
):
368
82
.
[PubMed]
1931-7557
8.
Ferrari
C
,
Nacmias
B
,
Bagnoli
S
,
Piaceri
I
,
Lombardi
G
,
Pradella
S
, et al
Imaging and cognitive reserve studies predict dementia in presymptomatic Alzheimer’s disease subjects
.
Neurodegener Dis
.
2014
;
13
(
2-3
):
157
9
.
[PubMed]
1660-2854
9.
Liao
YC
,
Liu
RS
,
Teng
EL
,
Lee
YC
,
Wang
PN
,
Lin
KN
, et al
Cognitive reserve: a SPECT study of 132 Alzheimer’s disease patients with an education range of 0-19 years
.
Dement Geriatr Cogn Disord
.
2005
;
20
(
1
):
8
14
.
[PubMed]
1420-8008
10.
Bozzali
M
,
Dowling
C
,
Serra
L
,
Spanò
B
,
Torso
M
,
Marra
C
, et al
The impact of cognitive reserve on brain functional connectivity in Alzheimer’s disease
.
J Alzheimers Dis
.
2015
;
44
(
1
):
243
50
.
[PubMed]
1387-2877
11.
Colangeli
S
,
Boccia
M
,
Verde
P
,
Guariglia
P
,
Bianchini
F
,
Piccardi
L
.
Cognitive Reserve in Healthy Aging and Alzheimer’s Disease: A Meta-Analysis of fMRI Studies
.
Am J Alzheimers Dis Other Demen
.
2016
Aug
;
31
(
5
):
443
9
.
[PubMed]
1533-3175
12.
Medaglia
JD
,
Pasqualetti
F
,
Hamilton
RH
,
Thompson-Schill
SL
,
Bassett
DS
.
Brain and cognitive reserve: translation via network control theory
.
Neurosci Biobehav Rev
.
2017
Apr
;
75
:
53
64
.
[PubMed]
0149-7634
13.
Bartrés-Faz
D
,
Arenaza-Urquijo
EM
.
Structural and functional imaging correlates of cognitive and brain reserve hypotheses in healthy and pathological aging
.
Brain Topogr
.
2011
Oct
;
24
(
3-4
):
340
57
.
[PubMed]
0896-0267
14.
Ridderinkhof
KR
,
van den Wildenberg
WP
,
Segalowitz
SJ
,
Carter
CS
.
Neurocognitive mechanisms of cognitive control: the role of prefrontal cortex in action selection, response inhibition, performance monitoring, and reward-based learning
.
Brain Cogn
.
2004
Nov
;
56
(
2
):
129
40
.
[PubMed]
0278-2626
15.
Zahodne
LB
,
Manly
JJ
,
Brickman
AM
,
Siedlecki
KL
,
Decarli
C
,
Stern
Y
.
Quantifying cognitive reserve in older adults by decomposing episodic memory variance: replication and extension
.
J Int Neuropsychol Soc
.
2013
Sep
;
19
(
8
):
854
62
.
[PubMed]
1355-6177
16.
Zahodne
LB
,
Manly
JJ
,
Brickman
AM
,
Narkhede
A
,
Griffith
EY
,
Guzman
VA
, et al
Is residual memory variance a valid method for quantifying cognitive reserve? A longitudinal application
.
Neuropsychologia
.
2015
Oct
;
77
:
260
6
.
[PubMed]
0028-3932
17.
Habeck
C
,
Razlighi
Q
,
Gazes
Y
,
Barulli
D
,
Steffener
J
,
Stern
Y
.
Cognitive Reserve and Brain Maintenance: Orthogonal Concepts in Theory and Practice
.
Cereb Cortex
.
2017
Aug
;
27
(
8
):
3962
9
.
[PubMed]
1460-2199
18.
Serra
L
,
Bruschini
M
,
Di Domenico
C
,
Gabrielli
GB
,
Marra
C
,
Caltagirone
C
, et al
Memory is Not Enough: The Neurobiological Substrates of Dynamic Cognitive Reserve
.
J Alzheimers Dis
.
2017
;
58
(
1
):
171
84
.
[PubMed]
1387-2877
19.
Christensen
H
,
Korten
AE
,
Jorm
AF
,
Henderson
AS
,
Jacomb
PA
,
Rodgers
B
, et al
Education and decline in cognitive performance: compensatory but not protective
.
Int J Geriatr Psychiatry
.
1997
Mar
;
12
(
3
):
323
30
.
[PubMed]
0885-6230
20.
Hatch
SL
,
Feinstein
L
,
Link
BG
,
Wadsworth
ME
,
Richards
M
.
The continuing benefits of education: adult education and midlife cognitive ability in the British 1946 birth cohort
.
J Gerontol B Psychol Sci Soc Sci
.
2007
Nov
;
62
(
6
):
S404
14
.
[PubMed]
1079-5014
21.
Le Carret
N
,
Lafont
S
,
Mayo
W
,
Fabrigoule
C
.
The effect of education on cognitive performances and its implication for the constitution of the cognitive reserve
.
Dev Neuropsychol
.
2003
;
23
(
3
):
317
37
.
[PubMed]
8756-5641
22.
Roldán-Tapia
L
,
García
J
,
Cánovas
R
,
León
I
.
Cognitive reserve, age, and their relation to attentional and executive functions
.
Appl Neuropsychol Adult
.
2012
;
19
(
1
):
2
8
.
[PubMed]
2327-9095
23.
Weintraub
S
,
Besser
L
,
Dodge
HH
,
Teylan
M
,
Ferris
S
,
Goldstein
FC
, et al
Version 3 of the Alzheimer Disease Centers’ Neuropsychological Test Battery in the Uniform Data Set (UDS)
.
Alzheimer Dis Assoc Disord
.
2018
Jan-Mar
;
32
(
1
):
10
7
.
[PubMed]
0893-0341
24.
Reed
BR
,
Mungas
D
,
Farias
ST
,
Harvey
D
,
Beckett
L
,
Widaman
K
, et al
Measuring cognitive reserve based on the decomposition of episodic memory variance
.
Brain
.
2010
Aug
;
133
(
Pt 8
):
2196
209
.
[PubMed]
0006-8950
25.
Estévez-González
A
,
Kulisevsky
J
,
Boltes
A
,
Otermín
P
,
García-Sánchez
C
.
Rey verbal learning test is a useful tool for differential diagnosis in the preclinical phase of Alzheimer’s disease: comparison with mild cognitive impairment and normal aging
.
Int J Geriatr Psychiatry
.
2003
Nov
;
18
(
11
):
1021
8
.
[PubMed]
0885-6230
26.
Misdraji
EL
,
Gass
CS
.
The Trail Making Test and its neurobehavioral components
.
J Clin Exp Neuropsychol
.
2010
Feb
;
32
(
2
):
159
63
.
[PubMed]
1380-3395
27.
Arbuthnott
K
,
Frank
J
.
Trail making test, part B as a measure of executive control: validation using a set-switching paradigm
.
J Clin Exp Neuropsychol
.
2000
Aug
;
22
(
4
):
518
28
.
[PubMed]
1380-3395
28.
Kortte
KB
,
Horner
MD
,
Windham
WK
.
The trail making test, part B: cognitive flexibility or ability to maintain set?
Appl Neuropsychol
.
2002
;
9
(
2
):
106
9
.
[PubMed]
0908-4282
29.
Joy
S
,
Kaplan
E
,
Fein
D
.
Speed and memory in the WAIS-III Digit Symbol—coding subtest across the adult lifespan
.
Arch Clin Neuropsychol
.
2004
Sep
;
19
(
6
):
759
67
.
[PubMed]
0887-6177
30.
Schwartz
CE
,
Rapkin
BD
,
Healy
BC
.
Reserve and Reserve-building activities research: key challenges and future directions
.
BMC Neurosci
.
2016
Sep
;
17
(
1
):
62
. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27633657
[PubMed]
1471-2202
31.
Darby
RR
,
Brickhouse
M
,
Wolk
DA
,
Dickerson
BC
;
Alzheimer’s Disease Neuroimaging Initiative
.
Effects of cognitive reserve depend on executive and semantic demands of the task
.
J Neurol Neurosurg Psychiatry
.
2017
Sep
;
88
(
9
):
794
802
.
[PubMed]
0022-3050
32.
Lavrencic
LM
,
Churches
OF
,
Keage
HA
.
Cognitive reserve is not associated with improved performance in all cognitive domains
.
Appl Neuropsychol Adult
.
2017
;
•••
:
1
13
.
[PubMed]
2327-9095
33.
Stern
Y
,
Gazes
Y
,
Razlighi
Q
,
Steffener
J
,
Habeck
C
.
A task-invariant cognitive reserve network
.
Neuroimage
.
2018
Sep
;
178
:
36
45
.
[PubMed]
1053-8119
34.
Jollant
F
,
Lawrence
NS
,
Olie
E
,
O’Daly
O
,
Malafosse
A
,
Courtet
P
, et al
Decreased activation of lateral orbitofrontal cortex during risky choices under uncertainty is associated with disadvantageous decision-making and suicidal behavior
.
Neuroimage
.
2010
Jul
;
51
(
3
):
1275
81
.
[PubMed]
1053-8119
35.
Tremblay
L
,
Schultz
W
.
Modifications of reward expectation-related neuronal activity during learning in primate orbitofrontal cortex
.
J Neurophysiol
.
2000
Apr
;
83
(
4
):
1877
85
.
[PubMed]
0022-3077
36.
Chavan
CF
,
Mouthon
M
,
Draganski
B
,
van der Zwaag
W
,
Spierer
L
.
Differential patterns of functional and structural plasticity within and between inferior frontal gyri support training-induced improvements in inhibitory control proficiency
.
Hum Brain Mapp
.
2015
Jul
;
36
(
7
):
2527
43
.
[PubMed]
1065-9471
37.
Aziz-Zadeh
L
,
Wilson
SM
,
Rizzolatti
G
,
Iacoboni
M
.
Congruent embodied representations for visually presented actions and linguistic phrases describing actions
.
Curr Biol
.
2006
Sep
;
16
(
18
):
1818
23
.
[PubMed]
0960-9822
38.
Yokoyama
S
,
Okamoto
H
,
Miyamoto
T
,
Yoshimoto
K
,
Kim
J
,
Iwata
K
, et al
Cortical activation in the processing of passive sentences in L1 and L2: an fMRI study
.
Neuroimage
.
2006
Apr
;
30
(
2
):
570
9
.
[PubMed]
1053-8119
39.
Karnath
HO
.
New insights into the functions of the superior temporal cortex
.
Nat Rev Neurosci
.
2001
Aug
;
2
(
8
):
568
76
.
[PubMed]
1471-003X
40.
Tranel
D
.
The left temporal pole is important for retrieving words for unique concrete entities
.
Aphasiology
.
2009
Jul
;
23
(
7-8
7 &AMP
):
867
84
.
[PubMed]
0268-7038
41.
Bordage
G
,
Zacks
R
.
The structure of medical knowledge in the memories of medical students and general practitioners: categories and prototypes
.
Med Educ
.
1984
Nov
;
18
(
6
):
406
16
.
[PubMed]
0308-0110
42.
Farmer
J
,
Knapp
D
,
Benton
GM
.
An elementary school environmental education field trip: long-term effects on ecological and environmental knowledge and attitude development
.
J Environ Educ
.
2007
;
38
(
3
):
33
42
. 0095-8964
43.
St Clair-Thompson
HL
,
Gathercole
SE
.
Executive functions and achievements in school: Shifting, updating, inhibition, and working memory
.
Q J Exp Psychol (Hove)
.
2006
Apr
;
59
(
4
):
745
59
.
[PubMed]
1747-0218
44.
Cotrena
C
,
Branco
LD
,
Cardoso
CO
,
Wong
CE
,
Fonseca
RP
.
The Predictive Impact of Biological and Sociocultural Factors on Executive Processing: The Role of Age, Education, and Frequency of Reading and Writing Habits
.
Appl Neuropsychol Adult
.
2016
;
23
(
2
):
75
84
.
[PubMed]
2327-9095
45.
Motes
MA
,
Gamino
JF
,
Chapman
SB
,
Rao
NK
,
Maguire
MJ
,
Brier
MR
, et al
Inhibitory control gains from higher-order cognitive strategy training
.
Brain Cogn
.
2014
Feb
;
84
(
1
):
44
62
.
[PubMed]
0278-2626
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