Cognitive reserve (CR) may reduce the risk of dementia. We summarized the effect of CR on progression to mild cognitive impairment (MCI) or dementia in studies accounting for Alzheimer’s disease (AD)-related structural pathology and biomarkers. Literature search was conducted in Web of Science, PubMed, Embase, and PsycINFO. Relevant articles were longitudinal, in English, and investigating MCI or dementia incidence. Meta-analysis was conducted on nine articles, four measuring CR as cognitive residual of neuropathology and five as composite psychosocial proxies (e.g., education). High CR was related to a 47% reduced relative risk of MCI or dementia (pooled-hazard ratio: 0.53 [0.35, 0.81]), with residual-based CR reducing risk by 62% and proxy-based CR by 48%. CR protects against MCI and dementia progression above and beyond the effect of AD-related structural pathology and biomarkers. The finding that proxy-based measures of CR rivaled residual-based measures in terms of effect on dementia incidence underscores the importance of early- and mid-life factors in preventing dementia later.

认知储备 (CR) 可以降低患痴呆症的风险。我们在考虑阿尔茨海默病 (AD) 相关结构病理学和生物标志物的研究中总结了 CR 对进展为轻度认知障碍 (MCI) 或痴呆的影响。文献检索在 Web of Science、PubMed、Embase 和 PsycINFO 中进行。相关文章是纵向的、英文的，并调查 MCI 或痴呆症的发病率。对九篇文章进行了荟萃分析，其中四篇将 CR 测量为神经病理学的认知残留，五篇作为复合心理社会代理（例如，教育）。高 CR 与 MCI 或痴呆的相对风险降低 47% 相关（汇总风险比：0.53 [0.35, 0.81]），基于残差的 CR 将风险降低 62%，基于代理的 CR 降低 48%。CR 在 AD 相关的结构病理学和生物标志物的影响之外防止 MCI 和痴呆进展。在对痴呆发病率的影响方面，基于代理的 CR 测量与基于残差的测量相媲美的发现强调了早期和中年因素在以后预防痴呆方面的重要性。