Abstract

This research is an integrative review of scientific evidence differentiating between cognitive reserve (CR) and brain maintenance concepts. Thus, we have examined how CR socio-behavioral proxies (i.e. education, occupational attainment, and leisure activities) may help to cope with age-related cognitive decline and negative consequences of brain pathology. We also analyze lifestyle factors associated with brain maintenance or the relative absence of change in neural resources over time. Medline and Web of Science databases were used for the bibliographic search in the last 20 years. Observational cohort studies were selected to analyze the effect of different CR proxies on cognitive decline, including dementia incidence, whereas studies employing functional neuroimaging (fMRI) were used to display the existence of compensation mechanisms. Besides, structural MRI studies were used to test the association between lifestyle factors and neural changes. Our findings suggest that education, leisure activities, and occupational activity are protective factors against cognitive decline and dementia. Moreover, functional neuroimaging studies have verified the existence of brain networks that may underlie CR. Therefore, CR may be expressed either through a more efficient utilization (neural reserve) of brain networks or the recruitment of additional brain regions (compensation). Finally, lifestyle factors such as abstaining from smoking, lower alcohol consumption, and physical activity contributed to brain maintenance and were associated with the preservation of cognitive function. Advances in multimodal neuroimaging studies, preferably longitudinal design, will allow a better understanding of the neural mechanisms associated with the prevention of cognitive decline and preservation of neural resources in aging.

摘要

这项研究是对区分认知储备（CR）和大脑维持概念的科学证据的综合综述。因此，我们研究了CR的社会行为代理（即教育，职业素养和休闲活动）如何帮助应对与年龄相关的认知能力下降和脑部病理学的负面后果。我们还分析了与大脑维护或神经资源随时间变化相对不相关的生活方式因素。在过去20年中，使用Medline和Web of Science数据库进行书目搜索。选择观察性队列研究来分析不同CR代理对认知下降（包括痴呆症发生率）的影响，而采用功能性神经影像学（fMRI）的研究则用于显示补偿机制的存在。除了，结构MRI研究用于检验生活方式因素与神经变化之间的关联。我们的发现表明，教育，休闲活动和职业活动是防止认知能力下降和痴呆的保护因素。此外，功能性神经影像学研究已经证实了可能构成CR的大脑网络的存在。因此，CR可以通过更有效地利用大脑网络（神经储备）或募集其他大脑区域（补偿）来表达。最后，诸如戒烟，降低饮酒量和体育锻炼等生活方式因素有助于大脑的维持，并与保持认知功能有关。多模态神经影像学研究的进展，最好是纵向设计，