Brain Reserve and Cognitive Training in the Elderly

Abstract

Given the precipitous forecast for dementia prevalence over the coming years, effective preventive strategies are of great importance.

Recent evidence linking mental activity and dementia risk invokes “brain reserve” as the mediating agent. 10–40 % of persons who satisfy post-mortem criteria for AD show no signs of cognitive impairment ante-mortem. Does brain reserve protect against amyloid load? Brain reserve has acquired several interpretations. The so-called hard version emphasizes a genetically based phenomenon, for example increased brain size or neural density. Another concept uses a “soft” analogy which is a flexible brain reserve compensating for neural dysfunction by motivating a great number of potential neural pathways. The latter, being the most reliable one, focuses on behavioural level by assessing frequency and range of participation in complex mental activities. Consequently, persons who have developed a wide spectrum of cognitive strategies for coping with complex problems perform very well in psychometric tests.