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Alzheimers Dement (N Y). 2019 Apr 10;5:118-128. doi: 10.1016/j.trci.2019.02.003. eCollection 2019.

General and domain-specific cognitive reserve, mild cognitive impairment, and dementia risk in older women.

Author information

1
Department of Neurology, University of Southern California, Los Angeles, CA, USA.
2
National Institute on Aging, Laboratory of Behavioral Neuroscience, Baltimore, MD, USA.
3
Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
4
Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, USA.
5
Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, USA.
6
Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA.
7
Graduate School of Education, University of California, Riverside, CA, USA.
8
Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.
9
Department of Psychiatry, Medical College of Wisconsin, Tosa Health Center, Milwaukee, WI, USA.
10
Department of Health Research & Policy (Epidemiology), Stanford University, Stanford, CA, USA.
11
Department of Neurology and Neurological Sciences, Stanford University, 259 Campus Drive, Stanford, CA, USA.
12
Department of Neurology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, USA.
13
Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, USA.

Abstract

Introduction:

In a geographically diverse sample of women, we asked whether cognitive reserve (CR) is best viewed as a general or cognitive domain-specific construct and whether some cognitive reserve domains but not others exert protective effects on risk of developing mild cognitive impairment (MCI) or dementia.

Methods:

Estimates of general and domain-specific CR were derived via variance decomposition in 972 cognitively intact women from the Women's Health Initiative Study of Cognitive Aging and Women's Health Memory Study Magnetic Resonance Imaging. Women were then followed up for 13 years.

Results:

General CR was the strongest predictor of reduced risk for both MCI and dementia, compared to domain-specific CR measures. Verbal memory, figural memory, and spatial CR were independently protective of MCI, but only verbal memory was independently associated with reduced risk for dementia.

Discussion:

Cognitive reserve is a heterogenous construct with valid quantitative measures identifiable across different neuropsychological processes associated with MCI and dementia.

KEYWORDS:

Cognitive reserve; Dementia; Mild cognitive impairment; Structural equation modeling

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