ArticleNeuropsychology2021
Functional reserve: The residual variance in instrumental activities of daily living not explained by brain structure, cognition, and demographics.
Article in Neuropsychology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cognitive reserve in individuals with frontotemporal dementia: a systematic review.Journal of clinical and experimental neuropsychology · 2024Pooled it
- Psychological characteristics and functional abilities in older adults with subjective cognitive complaints: A potential new target for early intervention.International psychogeriatrics · 2026Trial
- From Athletic Performance to Functional Ageing: Shared Genetic Architecture, Redox-Inflammatory Pathways and Functional Reserve Across the Life Course-A Narrative Review.Biomedicines · 2026Review
- Functional reserve mitigates cognitive-motor dual-task costs in older adults: insights from age, cohort, and behavioural strategies.European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity · 2026Article
- Mechanisms and Impact of Cognitive Reserve in Normal Aging and Alzheimer's Disease.Diagnostics (Basel, Switzerland) · 2025Review
- Evaluation of Activities of Daily Living: Current Insights and Future Horizons.Annals of geriatric medicine and research · 2025Review
- Left Frontoparietal Control Network Connectivity Moderates the Effect of Amyloid on Cognitive Decline in Preclinical Alzheimer's Disease: The A4 Study.The journal of prevention of Alzheimer's disease · 2024Article
- Beyond vision:Cataract and health status in old age, a narrative review.Frontiers in medicine · 2023Review
- Evidence for neuropsychological health disparities in Black Americans with HIV disease.The Clinical neuropsychologist · 2022Article
- Combined effects of older age and HIV disease on changes in everyday functioning over one year.Journal of neurovirology · 2022Article
- Pathological functional impairment: Neuropsychological correlates of the shared variance between everyday functioning and brain volumetrics.Frontiers in aging neuroscience · 2022Article
- Network Physiology in Aging and Frailty: The Grand Challenge of Physiological Reserve in Older Adults.Frontiers in network physiology · 2021Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveCognitive reserve is a concept that explains individual differences in resilience to brain pathology and susceptibility to poor late-life cognitive outcomes. We evaluate the analogous concept of "Functional Reserve," defined as the difference between observed functional abilities and those predicted by brain structure, cognitive performance, and demographics. This study aims to validate the construct of functional reserve by testing its utility in predicting clinical outcomes and exploring its predictors.
methodLongitudinal data collected annually for up to 7 years from 1,084 older adults (ndementia = 163; nMCI = 333; nCN = 523) were analyzed. Functional reserve was operationalized as the residual variance in the Lawton-Brody Instrumental Activities of Daily Living (IADL) Scale after accounting for demographics (sex/gender, race, ethnicity, education), neuropathology (gray matter, hippocampal, and white matter hyperintensity volumes), and cognition (executive function, verbal episodic memory, semantic memory, and spatial function). Structural equation models estimated (a) functional reserve's associations with 7-year changes in clinical diagnosis and disease severity and (b) predictors of functional reserve.
resultsFunctional reserve was lower in dementia versus cognitively normal individuals. Higher baseline functional reserve was associated with lower concurrent dementia severity and slower clinical progression and attenuated the association of cognition with concurrent dementia severity. Physical function and apathy were the strongest predictors of functional reserve.
conclusionsResults provide preliminary validation of functional reserve for explaining individual differences in susceptibility to IADL dysfunction independent of neuropathology, cognition, and demographics. Physical functioning and apathy are promising modifiable intervention targets to enhance functional reserve in the context of brain atrophy and cognitive decline. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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