Brain Power & Cognitive Reserve

Recently, the Health Beat Newsletter of the Harvard Medical School asked this question; what is cognitive reserve? The easiest metaphor to think of is your automobile. Imagine that you are driving down the highway at a comfortable 65 miles an hour (well within the speed limit) and you have your cruise control set. This could be how your brain is working under normal circumstances. However, as you start to pass a tractor trailer you realize that there is a car in front of you and you need to speed up very quickly; so, you push down on the accelerator very hard. If everything is working correctly, then your engine has the necessary “reserve power” so that you can accelerate to the point where you pass the truck safely. But suppose that your car needed a tune up and when you pushed the accelerator down it took several seconds for the engine to respond. Bad things would happen.

Now let’s think in terms of your brain. You were born with a certain amount of brain tissue that was still in the process of growing and establishing the appropriate connections. Over the course of the next 20 to 25 years your brain became what we can think of as a “normal” adult brain. In addition, if you give your brain additional training by going to school, exercising, reading, enjoying social activities, your brain develops additional “strength” which allows the user (meaning you) to think faster, to think more creatively, and to engage the world more effectively. Now imagine that you are now 70 years old. Your brain has been suffering from Alzheimer’s disease for the last 10-15 years, but no one has noticed.

Why ?

Well, it turns out that all those good things that you did for your brain in your youth and as an adult kept your brain “in tune” and functioning relatively normally. This means that as brain cells die because of the Alzheimer’s disease, your brain is able to compensate by using all these wonderful connections from your earlier life. Consequently, it will take you more time to decline to the point where your symptoms of dementia, or mild cognitive impairment become evident.

This was demonstrated very nicely by Professor Yaakov Stern of the Columbia University Taub Institute for the Research on Alzheimer’s Disease and the Aging Brain in a 1992 report in the Annals of Neurology. He used an imaging technique to measure the brain function of individuals with Alzheimer’s disease. He found that for a given level of dementia severity those people who had more education appeared to have more diseased brains. That is, those participants who had more education were able to withstand greater degrees of Alzheimer’s disease pathology (i.e., brain cell death). Subsequently, researchers around the world, including important studies to come from the University of Pittsburgh, have reported similar findings. For example, diabetes is known to influence the blood vessels in the body and in the brain. So, it is no surprise that people with diabetes exhibit symptoms of dementia before people who do not have diabetes.

The Brite Wellness program provides people with the opportunity to take part in activities that we know have a positive influence on brain health. The program of activities should have a positive effect on mood, physical health, and, we hope, will delay any worsening of cognitive functions among people with mild cognitive impairments.