Build This Brain Strength to Help Fight Dementia
- Austin Perlmutter MD
- 2 days ago
- 3 min read
How Cognitive Reserve Can Help Protect Your Brain Against Aging
By Austin Perlmutter, MD
With dementia now estimated to impact 42% of people who make it past age 55, everyone should be taking steps to help decrease risk for developing the condition. Yet while much of the conversation focuses on supplements, diet, and pharmaceuticals, one of the less publicized tools to mitigate risk could be one of the most important.
For background, it’s key to understand that as it relates to dementia, brain changes can begin decades before a person experiences symptoms of cognitive decline. Yet not all people with dementia-related changes in their brains experience clinical dementia, and there are major differences in the severity of cognitive impairment, even in people with similar brain pathology (like amyloid buildup). But why?
A major breakthrough in unpacking this complexity came from a 1994 study in the Journal of the American Medical Association (JAMA). In this publication, Dr. Yaakov Stern and his co-investigators looked at about 600 healthy adults aged 60 years or older and followed them for up to 4 years to look for development of dementia. They discovered that people who had more formal education or more complex occupations had a significantly lower chance (less than half) of development of dementia. They proposed that “increased educational and occupational attainment may reduce the risk of incident [Alzheimer’s disease], either by decreasing ease of clinical detection of AD or by imparting a reserve that delays the onset of clinical manifestations.”
This early work has since been expanded, and the framework described by the early work is now classified as “cognitive reserve” (CR). There is now an increased understanding that multiple methods of expanding brain connectivity and even growth of new brain cells could help to delay or potentially even offset the risk for developing dementia. Many now recommend various steps to help raise CR, which in addition to pursuing formal education and engaging in cognitively demanding tasks (e.g., a complex job) include certain leisure activities, exercise and social engagement.
It is important to note that the brain protection associated with higher CR isn’t necessarily a prevention of dementia itself, but rather, may promote a delayed decline. Research recently published in the journal Neurology suggests that having higher CR leads to a slowing of progression in stages of brain decline that precede a diagnosis of Alzheimer’s disease, potentially compressing the cognitive impairment into a shorter period of time after dementia is present. With all this in mind, what are practical strategies to help boost CR?
1. Lifelong Learning
Education is one of the strongest contributors to CR. Higher educational attainment is linked to a significantly lower dementia risk in many studies, including up to a 44% percent reduction in some data. Importantly, this isn’t just about early life schooling. Learning later in life is an excellent step to continue to promote CR.
2. Cognitive Training
In one of the largest trials of its type, researchers in the ACTIVE Cognitive Training Trial tested whether ten sessions of cognitive training (plus boosters after 11 and 35 months) could lead to improvements in cognition in around 3000 people. They found that reasoning and speed training led to improvements in brain function observable 10 years later.
3. Physical Activity
Regular physical activity may be the most important daily activity for promoting brain health, but specific to cognitive reserve, aerobic and resistance exercises may be especially beneficial for growing brain cells and protecting against dementia. One of the most striking examples is a 2011 study showing that one year of exercise (specifically walking) appeared to grow the brain’s memory center (the hippocampus).
4. Social Engagement
Strong and positive social interactions have been consistently linked with better brain health, but how? In a 2021 publication, researchers compared people’s social networks to brain imaging (MRI) testing. They found that people with more ability to span social roles had better cognitive testing and that this was linked to slowing of atrophy in parts of the brain linked to social processing.
5. Novelty
Our brains are tasked with responding to an incredible diversity of environmental inputs. However, consistently challenging ourselves with new experiences may be a way to beneficially augment this process to boost CR. To this end, learning a new instrument, a new language, traveling, or picking up a new hobby are great ways to inject novelty into your life.
A version of this article appeared first on Psychology Today
