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Conceptual and Measurement Challenges in Research on Cognitive Reserve

Published online by Cambridge University Press:  17 March 2011

Richard N. Jones*
Affiliation:
Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
Jennifer Manly
Affiliation:
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
M. Maria Glymour
Affiliation:
Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts
Dorene M. Rentz
Affiliation:
Department of Neurology, Brigham and Women's Hospital; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
Angela L. Jefferson
Affiliation:
Department of Neurology, Boston University Medical School, Boston, Massachusetts
Yaakov Stern
Affiliation:
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 Departments of Neurology and Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York
*
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

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)

Type
Special Series
Copyright
Copyright © The International Neuropsychological Society 2011

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