[Cognitive reserve: evidence, limitations and future research lines]

Education Level Modulates the Presence of Poststroke Depression and Anxiety, But It Depends on Age

ABSTRACT

Depression and anxiety are common complications after stroke and little is known about the modulatory roles of education and age. Our study aimed to evaluate the modulatory effects of education level on anxiety and depression after stroke and their effect on each age group. Adults with first stroke took part in this cross-sectional observational clinical study. We used the following instruments: Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Scale, Pittsburgh Sleep Quality Index, Barthel index, and Functional Independence Measure. There were 89 patients. The mean (SD) age was 58.01 (13) years, mean (SD) years of education was 9.91 (5.22), 55.1% presented depression symptoms and 47.2% anxiety symptoms, 56.2% were young adults and 43.8% were older adults. We identified a negative association between education and anxiety score (r = -0. 269, p = 0.011) and depression score (r = -0.252, p = 0.017). In the linear regression analysis, we found that education is negatively associated with HADS, but this influence was more consistent in young adults. In conclusion, a higher education level reduces the risk of depression and anxiety, but their effect is less consistent in older adults.

Relationship between Cognitive Reserve and Cognitive Impairment in Autonomous and Institutionalized Older Adults

It is necessary to determine which variables help prevent the presence of decline or deterioration during the aging process as a function of advancing age. This research analyses the relations between cognitive reserve (CR) and cognitive impairment in 300 individuals. It also aims to confirm the influence of different variables (gender, age, level of studies and institutionalization) in CR and in deterioration in a population of older adults. The results indicate that people with higher CR present less deterioration. Regarding the role of the sociodemographic variables in the level of deterioration and CR, there are no differences between men and women, but there are differences in the variables age, level of studies and institutionalization, in such a way that the older age the greater the cognitive deterioration, the higher the level of studies, the more RC and less deterioration and it was found that the non-institutionalized people present less deterioration and greater CR. It is affirmed that two people with similar clinical characteristics may present different levels of pathology, being the CR the explanation of this fact. The results obtained allow us to affirm that the measurement of CR is considered an essential variable for the diagnosis of neurodegenerative diseases.

Does bilingualism contribute to cognitive reserve? Cognitive and neural perspectives

OBJECTIVE

Cognitive reserve refers to how individuals actively utilize neural resources to cope with neuropathology to maintain cognitive functioning. The present review aims to critically examine the literature addressing the relationship between bilingualism and cognitive reserve to elucidate whether bilingualism delays the onset of cognitive and behavioral manifestations of dementia. Potential neural mechanisms behind this relationship are discussed.

METHOD

PubMed and PsycINFO databases were searched (through January 2014) for original research articles in English or Spanish languages. The following search strings were used as keywords for study retrieval: "bilingual AND reserve," "reserve AND neural mechanisms," and "reserve AND multilingualism."

RESULTS

Growing scientific evidence suggests that lifelong bilingualism contributes to cognitive reserve and delays the onset of Alzheimer's disease symptoms, allowing bilingual individuals affected by Alzheimer's disease to live an independent and richer life for a longer time than their monolingual counterparts. Lifelong bilingualism is related to more efficient use of brain resources that help individuals maintain cognitive functioning in the presence of neuropathology. We propose multiple putative neural mechanisms through which lifelong bilinguals cope with neuropathology. The roles of immigration status, education, age of onset, proficiency, and frequency of language use on the relationship between cognitive reserve and bilingualism are considered.

CONCLUSIONS

Implications of these results for preventive practices and future research are discussed.

How we compensate for memory loss in old age: adapting and validating the Memory Compensation Questionnaire (MCQ) for Spanish populations

Compensating entails using external strategies and mechanisms that help overcome or alleviate the decreasing memory function that comes with age. This study aims to adapt and validate the MCQ in the elderly Spanish population. A total of 403 elderly people aged between 65 and 92 in the city of Valencia (Spain) completed the questionnaire for the validation process. The factorial validity of the scale was tested using confirmatory factor analysis. The result showed a first order five-factor model with 23 items that met the criteria for model fit according to multiple fit indices. As a general conclusion, the adaptation into Spanish provided a reliable and valid measure of compensation in the elderly population, and it could potentially be useful in both clinical practice and research in the elderly.

[Does intellectual activity prevent cognitive impairment? Relationships between cognitive reserve and mild cognitive impairment]

An in-depth review is presented of the role that cognitive reserve plays in the emergence of (mild cognitive impairment (MCI), and its progression to dementia by using different indicators. The studies reviewed provide support to the hypothesis that the reserve influences the manifestation of symptoms of cognitive impairment and at least partially, in its progression to dementia. The role of indicators of reserve are discussed, such as educational level, work complexity and cognitive activity in these processes. A model is also presented that argues that people with MCI and low reserves show a steeper decline early in the process of deterioration, compared to the high level of reserve this marked deterioration would have at the end of the process, due to the protective role of this reserve. This raises the need for more empirical research to help consolidate this theoretical model.

[Psychological functioning and aging. Learning from longitudinal studies]

Population-based longitudinal studies are very useful tools for investigating the characteristics of the aging process among different geographical and socio-cultural contexts. On the other hand, these kind of projects look at a wide range of key issues of aging. In this review, most recent psychological findings in this field are analysed. The increasing interest in longitudinal studies for psychological variables is shown, as well as explicit links with other areas of study. Finally, main areas of improvement are identified according to future analysis of psychological variables, regarding both conceptual and methodological issues.