Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2014-0012
Trends in Psychiatry and Psychotherapy
Original Article

Measures of cognitive reserve in Alzheimer's disease

Medidas de reserva cognitiva na doença de Alzheimer

Margarida Sobral; Maria Helena Pestana; Constança Paúl

http://dx.doi.org/10.1590/2237-6089-2014-0012 Trends Psychiatry Psychother, vol.36, n3, p.160-168, 2014
PDF
SciELO
Downloads: 0
Views: 679

Abstract

INTRODUCTION: Cognitive reserve (CR), a hypothetical construct used to obtain information about cognitive aging, describes the capacity of the adult brain to cope with the effects of neurodegenerative processes. This study evaluated CR using a CR questionnaire (CRQ) and a set of variables (education, leisure activities, lifelong occupation) that inform CR. It also developed a CR index, validated the CRQ, and examined the correlation between the different CR measures.METHODS: Functional and neuropsychological capacities of 75 outpatients (mean age: 80.2 years) with a probable AD diagnosis were evaluated. Socio-demographic data and clinical variables were collected. Patients completed two questionnaires: the Participation in Leisure Activities throughout Life questionnaire, and the CRQ.RESULTS: Participants with a greater CR had higher scores in cognitive tests than the elderly with a lower CR. A CR index was developed. CRQ reliability was 0.795 (Cronbach's alpha). There was a close association between the CR Index and the CRQ.CONCLUSIONS: This study found an association between CR measures and education, occupation and participation in leisure activities. The CRQ seems to be a suitable instrument to measure CR in Portuguese populations.

Keywords

Alzheimer's disease, cognitive reserve, education, leisure activities, lifelong occupation, Cognitive Reserve Index, Cognitive Reserve Questionnaire

Resumo

INTRODUÇÃO: A reserva cognitiva (RC), um construto usado para informar sobre o envelhecimento cognitivo, descreve a capacidade do cérebro adulto em lidar com os efeitos de processos neurodegenerativos. Este estudo teve como objetivos avaliar a RC com o Questionário de RC (QRC) e através de variáveis (escolaridade, actividades de lazer, ocupação ao longo da vida) que informam sobre a RC; desenvolver um índice de RC; validar o QRC; e correlacionar as diferentes medidas de RC.MÉTODOS: Foram avaliadas as capacidades funcionais e neuropsicológicas de 75 doentes (idade média: 80,2 anos) com diagnóstico de provável doença de Alzheimer, seguidos em ambulatório. Os dados recolhidos incluíram variáveis sócio-demográficas e clínicas. Os pacientes completaram dois questionários: Participação em Atividades de Lazer ao Longo da Vida; e QCR.RESULTADOS: Os doentes com os níveis mais elevados de RC obtiveram os valores mais elevados nos testes cognitivos. Neste estudo foi desenvolvido um IRC. O QRC (versão portuguesa) teve uma fidelidade de 0,795 (alpha de Cronbach) e foi demonstrada uma associação alta entre o IRC e o QRC.CONCLUSÕES: Verificou-se a existência de uma associação entre as medidas de RC e a escolaridade, ocupação e participação em atividades de lazer. O CRQ pode ser considerado um instrumento adequado para medir o CR da população portuguesa.

Palavras-chave

Doença de Alzheimer, reserva cognitiva, escolaridade, atividades de lazer, ocupação ao longo da vida, Índice de Reserva Cognitiva, Questionário de Reserva Cognitiva

References

Berr C, Wancata J, Ritchie K. Prevalence of dementia in elderly in Europe. Eur Neuropsychopharmacol. 2005;15:463-71.

Cummings JL. Alzheimer's disease. N Engl J Med. 2004;351:56-67.

Jalbert JJ, Daiello LA, Lapane KL. Dementia of the Alzheimer type. Epidemiol Rev. 2008;30:15-34.

Ziegler-Graham K, Brookmeyer R, Johnson E, Arrighi HM. Worldwide variation in the doubling time of Alzheimer's disease incidence rates. Alzheimers Dement. 2008;4:316-23.

Katzman R, Terry R, DeTeresa R, Brown T, Davies P, Fuld P. Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques. Ann Neurol. 1988;23:138-44.

Siedlecki KL, Stern Y, Reuben A, Sacco RL, Elkind MS, Wright CB. Construct validity of cognitive reserve in a multiethnic cohort: The Northern Manhattan Study. J Int Neuropsychol Soc. 2009;15:558-69.

Scarmeas N, Albert SM, Manly JJ, Stern Y. Education and rates of cognitive decline in incident Alzheimer's disease. J Neurol Neurosurg Psychiatry. 2006;77:308-16.

Stern Y. Cognitive reserve in ageing and Alzheimer's disease. Lancet Neurol. 2012;11:1006-12.

Tucker AM, Stern Y. Cognitive reserve in aging. Curr Alzheimer Res. 2011;8:354-60.

Jones RN, Manly J, Glymour MM, Rentz DM, Jefferson AL, Stern Y. Conceptual and measurement challenges in research on cognitive reserve. J Int Neuropsychol Soc. 2011;17:593-601.

Zahodne LB, Manly JJ, Brickman AM, Siedlecki KL, Decarli C, Stern Y. Quantifying cognitive reserve in older adults by decomposing episodic memory variance: replication and extension. J Int Neuropsychol Soc. 2013;19:854-62.

Albert MS, Jones K, Savage CR, Berkman L, Seeman T, Blazer D. Predictors of cognitive change in older persons: MacArthur studies of successful aging. Psychol Aging. 1995;10:578-89.

Ganguli M, Ratcliff G, Huff FJ, Belle S, Kancel MJ, Fischer L. Effects of age, gender, and education on cognitive tests in a rural elderly community sample: norms from the Monongahela Valley Independent Elders Survey. Neuroepidemiology. 1991;10:42-52.

James BD, Boyle PA, Buchman AS, Bennett DA. Relation of late-life social activity with incident disability among community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2011;66:467-73.

Sobral M, Paúl C. Education, leisure activities and cognitive and functional ability of Alzheimer's disease patients: a follow-up study. Dement Neuropsychol. 2013;7:181-9.

Scarmeas N, Stern Y. Cognitive reserve: implications for diagnosis and prevention of Alzheimer's disease. Curr Neurol Neurosci Rep. 2004;4:374-80.

Fratiglioni L, Paillard-Borg S, Winblad B. An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurol. 2004;3:343-53.

Graves AB, Larson EB, Edland SD, Bowen JD, McCormick WC, McCurry SM. Prevalence of dementia and its subtypes in the Japanese American population of King County, Washington state. The Kame Project. Am J Epidemiol. 1996;144:760-71.

Helmer C, Letenneur L, Rouch I, Richard-Harston S, Barberger-Gateau P, Fabrigoule C. Occupation during life and risk of dementia in French elderly community residents. J Neurol Neurosurg Psychiatry. 2001;71:303-9.

Diagnostic and Statistical Manual of Mental Disorders, 4th ed, text revision (DSM-IV-TR). 2000.

McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984;34:939-44.

Rami L, Valls-Pedret C, Bartrés-Faz D, Caprile C, Solé-Padullés C, Castellvi M, et al. [Cognitive reserve questionnaire. Scores obtained in a healthy elderly population and in one with Alzheimer's disease]. Rev Neurol.. 2011;52:195-201.

Folstein MF, Folstein SE. A practical method for grading the cognitive state of patients for the clinician. J Psychiatri Res. 1975;12:189-98.

Guerreiro MS, Botelho MA, Leitão O, Castro-Caldas A, Garcia C. Avaliação breve do estado mental.Adaptação Portuguesa do Mini Mental State Examination (MMSE) (Folstein, Folstein, & McHugh, 1975). 1994.

Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982;140:566-72.

Mioshi E, Dawson K, Mitchell J, Arnold R, Hodges JR. The Addenbrooke's Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening. Int J Geriatr Psychiatry. 2006;21:1078-85.

Graffar M. Une methode de classification sociale d'echantillons de population. Courier. 1956;6:455.

Classificação Nacional de Profissões 2010. 2011.

Pestana MH, Gageiro JN. Análise de dados para Ciências Sociais: a complementaridade do SPSS,. 2008.

616b1272a953952da748ab04 trends Articles
Links & Downloads
2238-0019 (Electronic)
Trends Psychiatry Psychother ©2024 All rights reserved.

Trends Psychiatry Psychother

Share this page
Page Sections