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Cognitive reserve, cognition, and real-world functioning in MCI: A systematic review and meta-analysis
Ist Teil von
Journal of clinical and experimental neuropsychology, 2021-12, Vol.43 (10), p.991-1005
Ort / Verlag
England: Routledge
Erscheinungsjahr
2021
Quelle
Taylor & Francis Journals Auto-Holdings Collection
Beschreibungen/Notizen
To synthesize quantitatively the mild cognitive impairment (MCI) literature with respect to the relationship between cognitive reserve and neuropsychological and functional outcomes.
Participants with a diagnosis of MCI (total n = 7,871; 53% female) were included in this random-effects meta-analysis. Neuropsychological measures were combined into composite scores (e.g., overall cognitive functioning, screening measures, memory, language, visuospatial, attention/processing speed/working memory, executive functioning, and motor functioning). Measures assessing real-world abilities were combined into an activities of daily living (ADL) composite.
Nearly all neuropsychological composite values were significantly correlated with education, with effect sizes ranging from small to moderate. The effect between overall neuropsychological functioning and occupation was weak and varied by cognitive domain. For cognitively stimulating leisure activity, only overall neuropsychological functioning demonstrated a significant relationship, with a weak effect size (r = .16). In contrast, ADLs were most strongly associated with leisure experience (r = .27), with a negligible relationship with education (r = 0.08) and occupation (r = 0.09).
Of the cognitive reserve proxies examined in this study, participation in leisure activity had the largest magnitude of effect size with ADL functioning. This was in stark contrast to the negligible relationship found for education and occupation. Although education has been widely considered the most important cognitive reserve proxy with respect to cognition, this work questions whether other lifestyle factors may play a more important role in preserving real world functioning.