Skip to main content Accessibility help

Cognitive Activities During Adulthood Are More Important than Education in Building Reserve

  • Bruce R. Reed (a1) (a2), Maritza Dowling (a3), Sarah Tomaszewski Farias (a1), Joshua Sonnen (a4), Milton Strauss (a5), Julie A. Schneider (a6), David A. Bennett (a6) and Dan Mungas (a1)...


Cognitive reserve is thought to reflect life experiences. Which experiences contribute to reserve and their relative importance is not understood. Subjects were 652 autopsied cases from the Rush Memory and Aging Project and the Religious Orders Study. Reserve was defined as the residual variance of the regressions of cognitive factors on brain pathology and was captured in a latent variable that was regressed on potential determinants of reserve. Neuropathology variables included Alzheimer's disease markers, Lewy bodies, infarcts, microinfarcts, and brain weight. Cognition was measured with six cognitive domain scores. Determinants of reserve were socioeconomic status (SES), education, leisure cognitive activities at age 40 (CA40) and at study enrollment (CAbaseline) in late life. The four exogenous predictors of reserve were weakly to moderately inter-correlated. In a multivariate model, all except SES had statistically significant effects on Reserve, the strongest of which were CA40 (β = .31) and CAbaseline (β = .28). The Education effect was negative in the full model (β = –.25). Results suggest that leisure cognitive activities throughout adulthood are more important than education in determining reserve. Discrepancies between cognitive activity and education may be informative in estimating late life reserve. (JINS, 2011, 17, 615–624)


Corresponding author

Correspondence and reprint requests to: Bruce R. Reed, PhD., UC Davis Alzheimer's Disease Center, 150 Muir Road (127a), Martinez, CA 94553. E-mail:


Hide All
Akbaraly, T.N., Portet, F., Fustinoni, S., Dartigues, J.F., Artero, S., Rouaud, O., Berr, C. (2009). Leisure activities and the risk of dementia in the elderly: results from the Three-City Study. Neurology, 73(11), 854861.
Andel, R., Vigen, C., Mack, W.J., Clark, L.J., Gatz, M. (2006). The effect of education and occupational complexity on rate of cognitive decline in Alzheimer's patients. Journal of the International Neuropsychological Society, 12(01), 147152.
Bennett, D.A., Schneider, J.A., Arvanitakis, Z., Kelly, J.F., Aggarwal, N.T., Shah, R.C., Wilson, R.S. (2006). Neuropathology of older persons without cognitive impairment from two community-based studies. Neurology, 66(12), 18371844.
Bennett, D.A., Schneider, J.A., Bienias, J.L., Evans, D.A., Wilson, R.S. (2005). Mild cognitive impairment is related to Alzheimer disease pathology and cerebral infarctions. Neurology, 64(5), 834841.
Bennett, D.A., Schneider, J.A., Buchman, A.S., Mendes de Leon, C., Bienias, J.L., Wilson, R.S. (2005). The Rush Memory and Aging Project: study design and baseline characteristics of the study cohort. Neuroepidemiology, 25(4), 163175.
Bennett, D.A., Wilson, R.S., Schneider, J.A., Evans, D.A., Mendes de Leon, C.F., Arnold, S.E., Bienias, J.L. (2003). Education modifies the relation of AD pathology to level of cognitive function in older persons. Neurology, 60(12), 19091915.
Borenstein, A.R., Copenhaver, C.I., Mortimer, J.A. (2006). Early-life risk factors for Alzheimer disease. Alzheimer Disease and Associated Disorders, 20(1), 6372.
Browne, M., Cudek, R. (1993). Alternate ways of assessing model fit. In K. Bollen & J. Long (Eds.), Testing structural equation models (pp. 136162). Thousand Oaks, CA: Sage.
Crowe, M., Andel, R., Pedersen, N.L., Johansson, B., Gatz, M. (2003). Does participation in leisure activities lead to reduced risk of Alzheimer's disease? A prospective study of Swedish twins. Journal of Gerontology B Psychological Sciences and Social Sciences, 58(5), P249P255.
Dowling, N.M., Tomaszewski Farias, S., Reed, B.R., Sonnen, J.A., Strauss, M.E., Schneider, J.A., Mungas, D. (2011). Neuropathological associates of multiple cognitive functions in two community-based cohorts of older adults. Journal of the International Neuropsychological Society (this issue).
Engvig, A., Fjell, A.M., Westlye, L.T., Moberget, T., Sundseth, Ø., Larsen, V.A., Walhovd, K.B. (2010). Effects of memory training on cortical thickness in the elderly. Neuroimage, 52(4), 16671676.
Evans, D.A., Beckett, L.A., Albert, M.S., Hebert, L.E., Scherr, P.A., Funkenstein, H.H., Taylor, J.O. (1993). Level of education and change in cognitive function in a community population of older persons. Annals of Epidemiology, 3(1), 7177.
Fratiglioni, L., Wang, H.X. (2007). Brain reserve hypothesis in dementia. Journal of Alzheimer's Disease, 12(1), 1122.
Gatz, M., Prescott, C.A., Pedersen, N.L. (2006). Lifestyle risk and delaying factors. Alzheimer Disease and Associated Disorders, 20(3 Suppl. 2), S84S88.
Hu, L.-T., Bentler, P.M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 155.
Hultsch, D.F., Hertzog, C., Small, B.J., Dixon, R.A. (1999). Use it or lose it: engaged lifestyle as a buffer of cognitive decline in aging? Psychology and Aging, 14(2), 245263.
Jöreskog, K.G., Sörbom, D. (1996). LISREL 8: User's reference guide. Chicago: Scientific Software International.
Karp, A., Kareholt, I., Qiu, C., Bellander, T., Winblad, B., Fratiglioni, L. (2004). Relation of education and occupation-based socioeconomic status to incident Alzheimer's disease. American Journal of Epidemiology, 159(2), 175183.
Knäuper, B., Wittchen, H.U. (1994). Diagnosing major depression in the elderly: evidence for response bias in standardized diagnostic interviews? Journal of Psychiatric Research, 28(2), 147164.
Lachman, M.E., Agrigoroaei, S., Murphy, C., Tun, P.A. (2009). Frequent cognitive activity compensates for education differences in episodic memory. American Journal of Geriatric Psychiatry, 18(1), 410.
Lindstrom, H.A., Fritsch, T., Petot, G., Smyth, K.A., Chen, C.H., Debanne, S.M., Friedland, R.P. (2005). The relationships between television viewing in midlife and the development of Alzheimer's disease in a case-control study. Brain and Cognition, 58(2), 157165.
Muthén, B., Kaplan, D., Hollis, M. (1987). On structural equation modeling with data that are not missing completely at random. Psychometrika, 52(3), 431462.
Muthén, L.K., Muthén, B.O. (1998) –2007). Mplus user's guide (5th ed.). Los Angeles, CA: Muthén & Muthén.
Pratt, J.W. (1987). Dividing the indivisible: using simple symmetry to partition variance explained. In T. Pukkila & S. Puntanen (Eds.), Proceedings of the Second International Conference in Statistics (pp. 245260). Tampere, Finland: University of Tampere.
Reed, B.R., Mungas, D., Tomaszewski Farias, S., Harvey, D., Beckett, L., Widaman, K.F., DeCarli, C. (2010). Measuring cognitive reserve based on the decomposition of episodic memory variance. Brain, 133(Pt 8), 21962209.
Schmand, B., Smit, J.H., Geerlings, M.I., Lindeboom, J. (1997). The effects of intelligence and education on the development of dementia. A test of the brain reserve hypothesis. Psychological Medicine, 27(6), 13371344.
Schumacker, R.E., Lomax, R.G. (1996). A beginner's guide to structural equation modeling. Hillsdale, NJ, England: Lawrence Erlbaum Associates, Inc.
Soricelli, R.L. (2006). Medicine and the arts. A series of self portraits by William Utermohlen. Commentary. Academic Medicine, 81(11), 996997.
Stern, Y. (2009). Cognitive reserve. Neuropsychologia, 47(10), 20152028.
Thomas, D.R., Hughes, E., Zumbo, B.D. (1998). On variable importance in linear regression. Social Indicators Research, 45, 253275.
Thomas, D.R., Zhu, P., Decady, Y.J. (2007). Point estimates and confidence intervals for variable importance in multiple linear regression. Journal of Educational and Behavioral Statistics, 32, 6191.
Valenzuela, M.J., Sachdev, P. (2006a). Brain reserve and cognitive decline: a non-parametric systematic review. Psychological Medicine, 36(8), 10651073.
Valenzuela, M.J., Sachdev, P. (2006b). Brain reserve and dementia: a systematic review. Psychological Medicine, 36(4), 441454.
Wilson, R.S., Barnes, L.L., Bennett, D.A. (2003). Assessment of lifetime participation in cognitively stimulating activities. Journal of Clinical and Experimental Neuropsychology, 25(5), 634642.
Wilson, R.S., Beckett, L.A., Barnes, L.L., Schneider, J.A., Bach, J., Evans, D.A., Bennett, D.A. (2002). Individual differences in rates of change in cognitive abilities of older persons. Psychology and Aging, 17(2), 179193.
Wilson, R.S., Bennett, D.A., Bienias, J.L., Mendes de Leon, C.F., Morris, M.C., Evans, D.A. (2003). Cognitive activity and cognitive decline in a biracial community population. Neurology, 61(6), 812816.
Wilson, R.S., Bienias, J.L., Evans, D.A., Bennett, D.A. (2004). Religious orders study: overview and change in cognitive and motor speed. Neuropsychology and Cognition, 11(2–3), 280303.
Wilson, R.S., Mendes De Leon, C.F., Barnes, L.L., Schneider, J.A., Bienias, J.L., Evans, D.A., Bennett, D.A. (2002). Participation in cognitively stimulating activities and risk of incident Alzheimer disease. Journal of the American Medical Association, 287(6), 742748.
Wilson, R.S., Scherr, P.A., Hoganson, G., Bienias, J.L., Evans, D.A., Bennett, D.A. (2005). Early life socioeconomic status and late life risk of Alzheimer's disease. Neuroepidemiology, 25(1), 814.



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed