Author Information
Meng-Tien Wu, Kaohsiung Medical University, TaiwanYuan-Han Yang, Kaohsiung Medical University, Taiwan
Abstract
Introduction: Cognitive reserve (CR), often indexed by educational attainment, is proposed to buffer cognitive decline. This study examined cross-sectional effects of CR on global cognition across individuals with subjective memory complaint (SMC), mild cognitive impairment (MCI), Alzheimer’s disease (AD), and other dementias. Methods: A total of 532 participants were included: SMC (n = 103), MCI (n = 98), AD (n = 294), and other dementias (n = 37; including Lewy body dementia, Parkinson’s disease dementia, vascular dementia, and mixed/unknown types). Education served as the CR proxy. Global cognition was assessed using the Cognitive Ability Screening Instrument (CASI) and Mini-Mental State Examination (MMSE). Multiple linear regressions evaluated associations between CR and cognitive performance, adjusting for age and sex. Additional analyses compared cognition between high CR (>12 years of education) and low CR (≤12 years). Results: Stratified models showed significant positive CR effects in SMC (CASI: β = 0.570; MMSE: β = 0.477), MCI (CASI: β = 0.542; MMSE: β = 0.409), and AD (CASI: β = 0.517; MMSE: β = 0.528; all p < 0.001). In other dementias, CR predicted CASI (β = 0.425, p = 0.013) but only trend-level MMSE (β = 0.332, p = 0.057). High CR was associated with higher CASI scores in SMC, MCI, and AD (all p ≤ 0.006), and with higher MMSE scores only in AD (p < 0.001). Conclusion: CR is positively associated with global cognition from early subjective complaints through MCI and AD, highlighting its potential protective role across the dementia continuum.
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