Cognitive Reserve

Cognitive Reserve
Nakia Melecio Doctoral Candidate in Psychology



















Abstract
The definition of cognitive reserve (CR) includes a two-prong methodology for cognitive processing when the brain is challenged with some form of stress or adversity. There is a significant component of educational level in terms of level of impairment and resulting recovery, if applicable. Research is robust enough to outline and categorize CR and the relationship to multiple brain outcomes, to include but not limited to memory, cognitive functioning and brain damage. This paper will discuss the aforementioned in greater detail by offering a valid definition of CR and further discussing research methods and findings that support off-setting cognitive decline.














Cognitive Reserve
Considering biopsychological perspectives of amnesia and memory, there are many topics and sub-topics that come to mind. From infantile amnesia to false memories, there are so many sundry processes, or lack thereof, that deserve recognition as pressing concerns for brain function. One in particular is cognitive reserve, which is not necessarily one of the more popular areas of research; however, given the irregularity of brain damage, it is something that merits study. After all, there seems to be no rhyme or reason with how brain disorder or disease affects one patient versus the other. While there are some notable, extenuating circumstances, there is something to be said for the disjunction between the degree of brain damage and its outcome (Stern, 2001). "There have been many attempts to produce a coherent theoretical account of reserve" (Stern, 2001). Hence, this paper will explore this intriguing area of study, to include its premise and promise for neuropsychology.
Definition
It is probably important to note that the consideration for reserve against brain damage derives from frequent observation that there does not appear to be a direct relationship between the degree of brain pathology or brain damage and its associated clinical manifestation. "A proposed definition of cognitive reserve is the ability to optimize or maximize performance through differential recruitment of brain networks, which perhaps reflect the use of alternate cognitive strategies" (Stern, 2001). Theoretically, cognitive reserve (CR) encompasses both passive and active processes in the brain's attempt to either negotiate pathology or in terms of clinical expressions of the amount of sustained damage (Stern, 2001). While these two approaches are not mutually exclusive, together they more comprehensively exemplify the premise of CR.
Type Characteristics
For the purpose of this discussion, it would seem more practical to leverage active reserve in a pointed discussion about the brain's fundamental coping mechanisms. To put this in plain perspective, research indicates that cognitive reserve is quite simply a normal, active process that kicks into action when people are trying to compensate for their overload, or in more serious cases, this reserve steps it up to compensate for brain damage (Stern, 2001). This innate process is one that attempts to seek recovery and varies by individual according to mental experiences that may include but are not limited to education, work, and recreation (Fick et. al., 2009).
Moreover, researchers postulate that people with more education, thus higher intelligence, are designed to withstand more brain damage before deterioration commences. This theory indicates that brain processes are different in someone with more education, in that they are more efficient thinkers (Stern, 2001). In other words, the more memory, learning, and information people process, the better prepared they are to adjust to and overcome change, adversity, and impairment. Also, unlike its passive counterpart, critical threshold is believed to be quite individualized. This "tailored" approach also extends to how brain damage will actually affect each person. To clarify, the amount of damage will have different results in each person, period (Stern, 2001).
Research and Measurement
There are essentially three elements of reserve that dominate research, although there is more emphasis one two of the three. More specifically, while brain damage, clinical expression, and theoretical mediation are regarded, the former two crop up in most studies as it relates to the operational definition, in addition to how they are mediated in relation to each other (Stern, 2001). What this means is that all three are technically co-dependent on each other. While not a direct correlation, this affinity comes into play when enlisting variables, such as educational achievement or memory recall to gauge pathology progression (Stern, 2001).
Furthermore, indices of pathology provide clinical key indicators to assist with capturing degrees of severity as a result of some traumatic experience, whether inherent or otherwise. Interestingly enough, there is no direct measure of pathologic severity, so often times scientists turn to clinicopathologic studies, where even postmortem indices are considered. Not to stray too far from CR, this particular approach is often employed to gauge variances over a life span or just looking at early age versus post-mortem, as specified (Stern, 2001).
Memory
It would be remiss not to introduce memory into the equation of cognitive reserve. Memories are the brain's mechanism for storing and cataloging experiences. What differentiates memory from learning is the brain's ability to recall instances, not necessarily how an experience changes the brain. However, perhaps one of the most critical factors regarding memory is the simple fact without it, other processes, such as learning, would be experience repeated as if anew with little to no reactivation of brain cells or recall (Pinel, 2011). More specifically, the more information that is processed via memory, the more opportunity exists for recovery and even survival of mental infarctions. That said, it goes without saying that memory is susceptible to malfunction, depending on the severity of cognitive impairment, so in essence, memory and CR, in and of itself, work in tandem.
Conclusion
In conclusion, like most mental processes and associated incapacities, CR is not that cut and dry, and it is safe to say that the jury is still out on its exact causes and how it functions per person. It is quite fascinating to learn about the protective role that CR plays in cognitive functional and general health and wellness, as it basically serves as a moderator or defense when the brain is greeted with issues or conditions that attack normal functioning. The aforementioned only touches on CR and its implications in the grand scheme of things, as there is a plethora of other situations in which CR can be examined. In any case, in this case, the resolving facets of CR are worthy to stand in scrutiny of research that is absolutely necessary for prolonging optimal brain activity.
















References
Fick, D., Kolanowski, A., Beattie, E., & McCrow, J. (2009). Delirium in early-stage Alzheimer's Disease: Enhancing cognitive reserve as a possible preventive measure. Journal of Gerontological Nursing, 35(3), 30-8. Retrieved from ProQuest Health and Medical Complete. (Document ID: 1656540221).
Pinel, J. (2011). Biopsychology (8th ed.). Boston: Allyn & Bacon.
Stern, Y. (2001). What is cognitive reserve? Theory and research application of the reserve concept. Retrieved from http://cumc.columbia.edu/dept/sergievsky/cnd/pdfs/CogResTheory.pdf
Sumowski, J., Chairavalloti, N., Wylie, G., & Deluca, J. (2009). Cognitive reserve moderates the negative effect of brain atrophy on cognitive efficiency in multiple sclerosis. Journal of the International Neuropsychological Society: JINS, 15(4), 606-12. Retrieved November 8, 2011, from ProQuest Health and Medical Complete. (Document ID: 1775968351).


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COGNITIVE RESERVE


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Running Head: COGNITIVE RESERVE