ArticleAlzheimer's research & therapy2023
Quantitative estimate of cognitive resilience and its medical and genetic associations.
Article in Alzheimer's research & therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Food-Derived Omega-3 Fatty Acids and Cognitive Aging: Integrating Nutritional Neuroscience and Geroscience.Nutrients · 2026Review
- Cognitive functioning and nausea as stage-specific drivers of quality of life in breast cancer: a longitudinal network analysis.Health and quality of life outcomes · 2026Article
- Cognitive resilience to Alzheimer's disease characterized by cell-type abundance.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Predicting Alzheimer's Cognitive Resilience Score: A Comparative Study of Machine Learning Models Using RNA-seq Data.bioRxiv : the preprint server for biology · 2024Article
- Acceptability of virtual reality to screen for dementia in older adults.BMC geriatrics · 2024Article
- Development of a machine learning algorithm to predict the residual cognitive reserve index.Brain communications · 2024Article
- Understanding the molecular basis of resilience to Alzheimer's disease.Frontiers in neuroscience · 2023Review
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Authors and funding
18 authors.
Funding
Abstract
backgroundWe have proposed that cognitive resilience (CR) counteracts brain damage from Alzheimer's disease (AD) or AD-related dementias such that older individuals who harbor neurodegenerative disease burden sufficient to cause dementia remain cognitively normal. However, CR traditionally is considered a binary trait, capturing only the most extreme examples, and is often inconsistently defined.
methodsThis study addressed existing discrepancies and shortcomings of the current CR definition by proposing a framework for defining CR as a continuous variable for each neuropsychological test. The linear equations clarified CR's relationship to closely related terms, including cognitive function, reserve, compensation, and damage. Primarily, resilience is defined as a function of cognitive performance and damage from neuropathologic damage. As such, the study utilized data from 844 individuals (age = 79 ± 12, 44% female) in the National Alzheimer's Coordinating Center cohort that met our inclusion criteria of comprehensive lesion rankings for 17 neuropathologic features and complete neuropsychological test results. Machine learning models and GWAS then were used to identify medical and genetic factors that are associated with CR.
resultsCR varied across five cognitive assessments and was greater in female participants, associated with longer survival, and weakly associated with educational attainment or APOE ε4 allele. In contrast, damage was strongly associated with APOE ε4 allele (P value < 0.0001). Major predictors of CR were cardiovascular health and social interactions, as well as the absence of behavioral symptoms.
conclusionsOur framework explicitly decoupled the effects of CR from neuropathologic damage. Characterizations and genetic association study of these two components suggest that the underlying CR mechanism has minimal overlap with the disease mechanism. Moreover, the identified medical features associated with CR suggest modifiable features to counteract clinical expression of damage and maintain cognitive function in older individuals.
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