Higher ‘cognitive reserve’ associated with lower dementia risk


Older people with higher ‘cognitive reserve’ can expect to have a 35% lower risk of developing dementia compared to those with low levels, according to new ELSA research.


The study, published in the British Journal of Psychiatry used data from 12,280 adults aged 50 and older, who took part in the English Longitudinal Study of Ageing (ELSA) over a period of 15 years.


The study aimed to conceptualise ‘cognitive reserve' as a combined measure of a person’s educational attainment, occupational class, and leisure activities. These factors, gained over a person's lifetime are thought to be associated with cognition in later life.


As well as a 35% reduction in dementia risk, the researchers found that people who were employed in more complex occupations were at a decreased risk of a dementia diagnosis, compared to those with less complex jobs.


For people under the age of 80, increased years of education was associated with a decreased risk of dementia, compared to those with few years of education. Increased engagement in leisure activities was also associated with a reduced risk of dementia for people under the age of 85, compared to those who engaged less often.


These associations were independent of marital status, wealth, depressive symptoms, health behaviours and poor physical health.


Pamela Almeida-Meza, lead author, said: “This study contributes to our understanding of cognitive reserve by supporting the theory that our brain’s resilience can be improved all through our life through various mentally-effortful activities.


“The study highlights the importance of engaging in social, physical and cognitively stimulating recreational pursuits during adulthood and older age, especially for those individuals who might not have been able to benefit from other protective activities earlier in their life.”


Profesor Andrew Steptoe, director of ELSA said: “The disappointing results of pharmacological treatment trials for dementia highlight the need to redouble efforts at prevention. Although we cannot draw causal conclusions from this analysis, our study suggests that the maintenance of an active mental and social life in later years may be beneficial.”


This study provides promising avenues for public health interventions as Dr Dorina Cadar, senior author, says “Our results show that leisure activities play an important role in dementia prevention, in addition to education and occupation complexity.


"Taking into consideration the nature-nurture debate, we can consider that at least to a certain degree, cognitive reserve is both acquired and inherited. Therefore, I would like to believe that we can influence, direct and control our environment, with important implications for our subsequent health.”


Almeida-Meza, P., Steptoe, A., & Cadar, D. (2020). Markers of cognitive reserve and dementia incidence in the English Longitudinal Study of Ageing. The British Journal of Psychiatry, 1-9.

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