Journal of the International Neuropsychological Society

Special Series

Conceptual and Measurement Challenges in Research on Cognitive Reserve

Richard N. Jonesa1a2 c1, Jennifer Manlya3, M. Maria Glymoura4, Dorene M. Rentza5, Angela L. Jeffersona6 and Yaakov Sterna3a7

a1 Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

a2 Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts

a3 Taub Institute for Research on Alzheimer's Disease and the Aging Brain and the Department of Neurology, Columbia University Medical Center, New York, New York

a4 Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts

a5 Department of Neurology, Brigham and Women's Hospital; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

a6 Department of Neurology, Boston University Medical School, Boston, Massachusetts

a7 Departments of Neurology and Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York

Abstract

Cognitive reserve, broadly conceived, encompasses aspects of brain structure and function that optimize individual performance in the presence of injury or pathology. Reserve is defined as a feature of brain structure and/or function that modifies the relationship between injury or pathology and performance on neuropsychological tasks or clinical outcomes. Reserve is challenging to study for two reasons. The first is: reserve is a hypothetical construct, and direct measures of reserve are not available. Proxy variables and latent variable models are used to attempt to operationalize reserve. The second is: in vivo measures of neuronal pathology are not widely available. It is challenging to develop and test models involving a risk factor (injury or pathology), a moderator (reserve) and an outcome (performance or clinical status) when neither the risk factor nor the moderator are measured directly. We discuss approaches for quantifying reserve with latent variable models, with emphasis on their application in the analysis of data from observational studies. Increasingly latent variable models are used to generate composites of cognitive reserve based on multiple proxies. We review the theoretical and ontological status of latent variable modeling approaches to cognitive reserve, and suggest research strategies for advancing the field. (JINS, 2011, 17, 593–601)

(Received June 03 2010)

(Revised December 16 2010)

(Accepted December 20 2010)

(Online publication March 17 2011)

Correspondence:

c1 Correspondence and reprint requests to: Richard N. Jones, Sc.D., Institute for Aging Research, Hebrew SeniorLife, Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1200 Centre Street, Boston, MA 02131. E-mail: jones@hrca.harvard.edu

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