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The indirect effect of cognitive reserve on the relationship between age and cognition in pathological ageing: A cross-sectional retrospective study in an unselected and consecutively enrolled sample |
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| Authors: | Francesco Giaquinto,Giorgia Tosi,Chiara Abbatantuono,Ilaria Pepe,Marika Iaia,Luigi Macchitella,Ezia Rizzi,Maria Fara De Caro,Daniele Romano,Paolo Taurisano,Paola Angelelli |
| Affiliation: | 1. Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy;2. Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy Psychology Department, University of Milano-Bicocca, Milan, Italy Contribution: Data curation, Formal analysis, Methodology, Writing - original draft, Writing - review & editing;3. Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy Contribution: Data curation, Investigation, Writing - original draft, Writing - review & editing;4. Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy Contribution: Data curation, Investigation, Writing - original draft;5. Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy Contribution: Writing - original draft, Writing - review & editing;6. Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy Scientific Institute I.R.C.C.S. “E. Medea”- Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi, Italy Contribution: Writing - original draft, Writing - review & editing;7. Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy Psychology Department, University of Milano-Bicocca, Milan, Italy Contribution: Writing - original draft, Writing - review & editing;8. Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy Contribution: Investigation, Project administration, Resources, Supervision, Writing - original draft;9. Psychology Department, University of Milano-Bicocca, Milan, Italy Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Project administration, Resources, Supervision, Writing - original draft, Writing - review & editing;10. Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy;11. Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy Contribution: Funding acquisition, Project administration, Resources, Supervision, Writing - original draft, Writing - review & editing |
| Abstract: | Cognitive reserve (CR) allows individuals to maintain cognitive functionality even in the presence of pathologies. The compensation hypothesis suggests that CR plays an indirect role between age and cognitive decline, contrasting the negative effect of ageing on cognition. We test this hypothesis in an unselected and consecutively enrolled sample of memory clinic attendees (n = 134) who completed the CR Index questionnaire and three neuropsychological tests assessing global cognition (MMSE, FAB, CDT). Participants were divided into two groups based on standard diagnostic criteria (DSM-5): those who were cognitively impaired (n = 92) and those who were preserved (n = 42). A principal component analysis was used to extract a composite measure of global cognitive functioning from the three neuropsychological tests, and mediation analysis was used to examine the relationship between CR, age and global cognitive functioning in the two groups. Results revealed that: (i) age had a significant direct negative effect on the global cognitive score in both groups; (ii) the three socio-behavioural proxies of CR together suppress the direct negative relationship between age and global cognitive score in cognitively impaired patients but not in cognitively preserved participants. This study confirms the association between CR, age and cognition and allows us to validate its role in a population with cognitive impairment and extend findings to a low-to-middle educated population. These results hold important implications for public health and wellness promotion, emphasising the beneficial role of maintaining healthy and active physical, cognitive and social lifestyles. |
| Keywords: | ageing cognition cognitive reserve principal component analysis |