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      Cognitive reserve and the severity of Alzheimer’s disease Translated title: Reserva cognitiva e a severidade da doença de Alzheimer

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          Abstract

          Alzheimer´s disease (AD) is a clinical syndrome caused by neurodegeneration and characterized by a progressive deterioration in cognitive ability and capacity for independent living. Cognitive reserve (CR) describes the capacity of the adult brain to cope with the effects of the neurodegenerative process and to minimize the clinical manifestation of pathology of dementia. The aim of this study was to evaluate the association of CR and the severity of AD.Method This study was cross-sectional. Functional and neuropsychological abilities of 75 outpatients with probable AD diagnosis were evaluated. Patients completed two questionnaires, “Participation in leisure activities throughout life” and CR Questionnaire.Result The relationship between Clinical Dementia Rating (CDR) and the level of CR was statistically significant (likelihood ratio (LR), p = 0.015).Conclusion The level of CR influenced the severity of dementia. This study suggests that AD patients with higher CR may benefit against cognitive decline after diagnosis of AD.

          Translated abstract

          Doença de Alzheimer (DA) é uma síndrome neurodegenerativa caracterizada por uma deterioração progressiva das capacidades cognitivas e das competências para uma vida independente. A reserva cognitiva (RC) descreve a capacidade do cérebro adulto em lidar com os efeitos deste processo neurodegenerativo e minimizar a manifestação clínica da patologia de demência. O objetivo deste trabalho foi avaliar a associação entre RC e a severidade da DA.Método Este estudo foi transversal. Foram avaliadas as competências funcionais e neuropsicológicas de 75 pacientes com diagnóstico provável de DA. Os pacientes completaram dois questionários, “Participação em atividades de lazer ao longo da vida” e o Questionário de RC.Resultados A relação entre o nível de Clinical Dementia Rating (CDR) e de RC foi estatisticamente significativa (likelihood ratio (LR), p = 0,015).Conclusão O nível de RC influenciou a severidade da demência. Este estudo sugere que os doentes com DA com um maior nível de RC podem beneficiar de proteção relativamente ao declínio cognitivo após o diagnóstico de DA.

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          Most cited references25

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          Cognitive reserve in aging.

          Cognitive reserve explains why those with higher IQ, education, occupational attainment, or participation in leisure activities evidence less severe clinical or cognitive changes in the presence of age-related or Alzheimer's disease pathology. Specifically, the cognitive reserve hypothesis is that individual differences in how tasks are processed provide reserve against brain pathology. Cognitive reserve may allow for more flexible strategy usage, an ability thought to be captured by executive functions tasks. Additionally, cognitive reserve allows individuals greater neural efficiency, greater neural capacity, and the ability for compensation via the recruitment of additional brain regions. Taking cognitive reserve into account may allow for earlier detection and better characterization of age-related cognitive changes and Alzheimer's disease. Importantly, cognitive reserve is not fixed but continues to evolve across the lifespan. Thus, even late-stage interventions hold promise to boost cognitive reserve and thus reduce the prevalence of Alzheimer's disease and other age-related problems.
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            Mini-mental state". A practical method for grading the cognitive state of patients for the clinician

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              The continuing effects of substantively complex work on the intellectual functioning of older workers.

              Using a nationally representative sample of employed men and women in this longitudinal study, the authors extended for another 20 years findings based on 1964 and 1974 data (Kohn & Schooler, 1983) that substantively complex work improves intellectual functioning. This study provides evidence that intellectual functioning and substantive complexity of work continue to reciprocally affect each other. In addition, it shows that the intellectual flexibility measure used earlier (Kohn & Schooler, 1978, 1983) is highly correlated with more standard measures of intellectual functioning. Most importantly, it shows that, although substantively complex work significantly increased the level of intellectual functioning of both the younger and older halves of the sample, the effect is significantly greater among the older workers.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo )
                1678-4227
                June 2015
                : 73
                : 6
                : 480-486
                Affiliations
                [1 ] Hospital de Magalhães Lemos Portugal
                [2 ] Universidade do Porto Portugal
                [3 ] Instituto Universitário de Lisboa Portugal
                Article
                S0004-282X2015000600480
                10.1590/0004-282X20150044
                26083882
                310772ad-27e2-467b-a5e2-2196ab9e5139

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-282X&lng=en
                Categories
                NEUROSCIENCES
                PSYCHIATRY

                Neurosciences,Clinical Psychology & Psychiatry
                Alzheimer´s disease,cognitive reserve,education,leisure activities,lifelong occupation,doença de Alzheimer,reserva cognitiva,educação,atividades de lazer,ocupação ao longo da vida

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