Cognitive Reserve and Related Constructs: A Unified Framework Across Cognitive and Brain Dimensions of Aging.
Cognitive Reserve and Related Constructs: A Unified Framework Across Cognitive and Brain Dimensions of Aging.
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DOI：
10.3389/fnagi.2022.834765
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发表时间：
2022
影响因子：
4.8
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中科院分区：
文献类型：
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认知储备及其相关构式对衰老相关研究具有重要意义，但由于目前还没有统一的命名法，因此需要术语的一致性和澄清。我们对储备、维持和恢复力的概念提出了一套新的定义，并引用了适用于认知和大脑的平行概念。我们对储备和恢复力的定义与词典对这些术语的定义相当吻合。我们展示了由常用的概念和操作定义之间的不一致引起的逻辑/方法问题。在我们看来，认知储备应该在概念上定义为一个人在给定时间点的认知资源总量。智商和教育是认知储备的常见操作定义（通常称为代理）的例子。许多研究人员在概念上将认知储备定义为一种属性，它允许在面对衰老或病理时表现得比预期更好。表现比预期的要好，在统计上是通过互动来证明的，而在互动中，调节者通常是智商或教育水平。其结果是认知储备既是调节者，又是调节效应本身的不可调和的局面。我们提出的命名法解决了这种逻辑上的不一致，将比预期表现更好的行为定义为认知弹性。因此，在我们的使用中，我们将测试高认知储备赋予更大认知弹性的假设。操作定义（所谓的代理）不应将可能影响储备的因素（如职业复杂性或参与认知活动）与认知储备本身混为一谈。由于资源可能随着衰老或病理而枯竭，一个人的认知储备水平可能会随着时间的推移而改变，并取决于何时进行评估。因此，除了认知储备和认知弹性外，我们还将认知储备的维持与大脑维护并行。然而，如果教育是衡量老年人的储备，它就排除了评估储备的变化或维持。最后，我们讨论了将抵抗作为弹性的一个子类，反向因果关系，在某些不利因素下使用剩余分数来评估表现优于预期，以及在不同研究中构成高与低认知储备的因素。
Cognitive reserve and related constructs are valuable for aging-related research, but consistency and clarification of terms is needed as there is still no universally agreed upon nomenclature. We propose a new set of definitions for the concepts of reserve, maintenance, and resilience, and we invoke parallel concepts for each that are applicable to cognition and to brain. Our definitions of reserve and resilience correspond reasonably well to dictionary definitions of these terms. We demonstrate logical/methodological problems that arise from incongruence between commonly used conceptual and operational definitions. In our view, cognitive reserve should be defined conceptually as one’s total cognitive resources at a given point in time. IQ and education are examples of common operational definitions (often referred to as proxies) of cognitive reserve. Many researchers define cognitive reserve conceptually as a property that allows for performing better than expected cognitively in the face of aging or pathology. Performing better than expected is demonstrated statistically by interactions in which the moderator is typically IQ or education. The result is an irreconcilable situation in which cognitive reserve is both the moderator and the moderation effect itself. Our proposed nomenclature resolves this logical inconsistency by defining performing better than expected as cognitive resilience. Thus, in our usage, we would test the hypothesis that high cognitive reserve confers greater cognitive resilience. Operational definitions (so-called proxies) should not conflate factors that may influence reserve—such as occupational complexity or engagement in cognitive activities—with cognitive reserve itself. Because resources may be depleted with aging or pathology, one’s level of cognitive reserve may change over time and will be dependent on when assessment takes place. Therefore, in addition to cognitive reserve and cognitive resilience, we introduce maintenance of cognitive reserve as a parallel to brain maintenance. If, however, education is the measure of reserve in older adults, it precludes assessing change or maintenance of reserve. Finally, we discuss consideration of resistance as a subcategory of resilience, reverse causation, use of residual scores to assess performing better than expected given some adverse factor, and what constitutes high vs. low cognitive reserve across different studies.