- Open Access
Concepts for brain aging: resistance, resilience, reserve, and compensation
© The Author(s). 2019
- Published: 11 March 2019
A primary goal of research in cognitive impairment and dementia is to understand how some individuals retain sufficient cognitive function for a fulfilling life while many others are robbed of their independence, sometimes their essence, in the last years and decades of life. In this commentary, we propose operational definitions of the types of factors that may help individuals retain cognitive function with aging. We propose operational definitions of resistance, resilience, reserve, with an eye toward how these may be measured and interpreted, and how they may enable research aimed at prevention. With operational definitions and quantification of resistance, resilience, and reserve, a focused analytic search for their determinants and correlates can be undertaken. This approach, essentially a search to identify protective risk factors and their mechanisms, represents a relatively unexplored pathway toward the identification of candidate preventive interventions.
- Reserve capacity
- Alzheimer’s disease
With operational definitions of resistance, resilience, and reserve, a focused analytic search for their predictors and correlates can be undertaken. This will require distinguishing and measuring each independently, and then employing those measures as distinct endpoints to identify their individual determinants. This approach, essentially a search to identify protective risk factors and their mechanisms, represents a relatively unexplored pathway toward the identification of candidate preventive interventions.
We would like to acknowledge the following foundation and grants:
The Chia-Ling Chang Fund of the Hawaii Community Foundation.
NIA grant UF1AG053983, Cognitive Resilience to Alzheimer Neuropathologic Changes in the Honolulu-Asia Aging Study and the Nun Study.
NIA grant UF1AG057707, Neuropathologic Substrates for Motor and Cognitive Impairment in Three Existing Cohort Studies of Alzheimer’s Disease and Related Dementias.
Availability of data and materials
Data are not available.
TM, BC, MC, SE, MF, LH, CK, and LW are responsible for the study concept and design, interpretation, and critical revision of the manuscript for intellectual content. All authors read and approved the final manuscript.
Ethics approval and consent to participate
Table 1 data are from a previous publication in Neurology . The Nun Study (NS) was reviewed and approved by Universities of Kentucky and Minnesota institutional review boards (IRBs). Participating School Sisters of Notre Dame had agreed to autopsy prior to death, with final authorizations provided by the Provincial Leader. The Honolulu Asia Aging Study (HAAS) was reviewed and approved by the Kuakini Hospital IRB. A consent form was signed by participants at every cycle (12 from 1965 to 2012), including consent for use of information and materials for research purposes by researchers and their colleagues, including NIH- associated, with no ending of this permission. HAAS autopsy acquisition procedure required notification of a participant’s death by family member, hospital, medical examiner’s office, or other source, with permission for autopsy and research use of information provided by next of kin.
Consent for publication
SE serves on clinical trial Data Safety and Monitoring Boards for Eli Lilly and Suven Life Sciences. The other authors declare that they have no competing interests.
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