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Resilience: building cognitive reserve

Resilience: Building Cognitive Reserve
Hello, my name is Sabina Brennan and I’m going to talk to you about resilience and brain health. Did you brush your teeth this morning, I ask. I did, yes, you answer. Will you brush them again this evening, I ask. I will, of course, you answer, looking at me like I’m a little bit mad. So what did you do for your brain health today, I ask. And you look at me like maybe I’m not the mad one in this conversation. You’re not alone. Most people score about 100% percent on dental health and 0% on brain health. How crazy is that? Of course you need your teeth to eat, to speak, to smile, and so they’re super important.
But you need your brain for everything, and I mean everything. There’s not one thing that you can do without your brain. You can’t watch this video. You can’t sit up. Come to think of it, you can’t even brush your teeth without your brain. So brain health matters. You were obviously a smart kid because you grasped the complex concept of investment at a very young age. Time spent now reaps future benefits. You developed a dental habit that includes daily brushing because you know that the time you invest in brushing your teeth today extends the life of your teeth, protecting against tooth decay and dental pain in the future.
You know that other activities like flossing, dental visits, and diet offer further protection. Now, as a grown up, you came to understand that even if you do everything that you’re supposed to do your investment doesn’t come with an absolute guarantee, but rather reduces the risk of pain and delays the onset of decay. Nonetheless, you learned that the benefits are well worth the time invested. Well the same principle applies to brain health. Certain activities offer protection against decline in brain function in later life, while some lifestyle factors increase your risk of developing diseases that affect brain function, such as Alzheimer’s disease and other dementias.
Now, the important take home message is that key lifestyle changes and activities that reduce risk or offer protection can easily be incorporated into your daily routine. However, as is the case with dental health, developing good brain health habits is not an absolute guarantee but there is plenty of evidence to suggest that it is definitely a worthwhile investment if you fancy holding on to important functions, like memory, for as long as possible. The brain is constantly changing and our behaviours and our experience can help to shape it at any age.
There is no direct relationship between the extent of injury to the brain or the degree of disease pathology, so the physical signs of disease in the brain, and the clinical manifestations or symptoms of the disease or the brain damage. So, for example, a stroke of a given magnitude can produce profound functional impairment in one patient while having minimal effect on another. Furthermore, researchers have found that about 25% of people who, during autopsy, fulfil pathological criteria for Alzheimer’s disease are actually clinically intact during life. That means that they functioned normally without any perceptible symptoms of dementia. So some people are resilient.
They have a better ability to maintain brain function as they age even if they develop the physical damage associated with dementia. Research tells us that this resilience, known also as cognitive reserve, is linked to lifestyle factors including education and carrying out stimulating tasks. Now, researchers interested in understanding how education and stimulating activities interact to contribute to cognitive reserve followed 488 older adults who were taking part in the Bronx healthy ageing study. Stimulating activities that the people in the study engaged in included reading, writing, crossword puzzles, games, discussions, and even playing music. Over the course of the five year study 101 people develop dementia. But what the researchers found surprised them, and it continues to surprise me.
Just one every day activity, that’s one activity for one day per week, delayed the onset of rapid memory loss for two months. Furthermore, they found that this positive effect occurred irrespective of education level. So, stimulating your brain every day is good for your brain even if you finished school before you were a teenager. I don’t know about you, but that sounds like a pretty good return on investment. So, next time you brush your teeth use it as a reminder to do something that’s good for your brain health every day.

What is cognitive reserve? Why is it important? How can you build reserve?

When a hard time hits, it helps to have something in reserve. In an economic recession, savings can get you through the tough patch, and in nature, animals that hibernate stock up on stored energy before they settle down for the winter.

Some scientists believe that our brains can also hold some reserve to ward off the impacts of damage over time.

Some people are able to maintain better brain function as they age, even if they develop the physical damage associated with dementia. This protective ‘cognitive reserve’ appears to be linked to modifiable factors such as:

  • The level of education reached
  • Carrying out cognitively demanding tasks
  • Being socially active

In the video, Dr Sabina Brennan mentions how the Bronx Healthy Ageing study found that:

Just one everyday activity (one activity for one day per week) delayed the onset of rapid memory loss for two months.

These were activities including reading, writing, crossword puzzles, games, discussions and music. So engaging in late life cognitive activities can influence your levels of cognitive reserve, irrespective of when you finished school.

  • What changes could you make to build reserve?
  • Have you ever been described as resilient, or do you know anyone that you would describe as resilient?
  • Have you ever come across resilience in other areas of health?
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