Mind power – “Cognitive Reserve”

An important concept that is crucial to the understanding of cognitive health is known as cognitive reserve. You can think of cognitive reserve as your brain's ability to automatically improvise and find alternate ways of getting a job done. READ MORE

Just like a powerful car that enables you to engage another gear and suddenly accelerate to avoid an obstacle, your brain can change the way it operates and thus make stored resources available to cope with challenges. Cognitive reserve is developed by a lifetime of education and curiosity which assists to build a reserve of thinking abilities, this can compensate when losses occur due to normal ageing and disease. 

The concept of cognitive reserve originated in the late 1980s, when researchers described individuals with no apparent symptoms of dementia who were nonetheless found at autopsy to have brain changes consistent with advanced Alzheimer's Disease (currently the most common form of dementia). These individuals did not show symptoms of the disease while they were alive, because they had a large enough cognitive reserve to offset the damage and thus continue to function well. 

Since then, research has shown that people with greater cognitive reserve are better able to stave off or slow down obvious signs of the degenerative brain changes associated with Dementia, or other conditions that can affect the brain such as such as Parkinson’s Disease, Multiple Sclerosis, or Stroke. A more robust cognitive reserve can also help you function better for longer if you're exposed to unexpected life events, such as stress, surgery, or toxins in the environment. Such circumstances demand extra effort from your brain—like requiring a car to engage another gear.

Harvard University (USA) research says that it is important to remember that having a healthy body is key to a healthy brain. 

They list 6 elements that can help to improve brain power.

• Eat a plant-based diet.
• Exercise regularly.
• Get enough sleep, but not too much sleep.
• Manage stress.
• Nurture social contacts.
• Continue to challenge your brain.

The Harvard researchers emphasize the importance of cultivating these factors together, as they reinforce each other and lead to optimal brain health, also known as cognitive health.

The first four factors – concerning diet, exercise, sleep, and stress reduction – can be seen as indirect support for cognitive health. Together, they represent the “healthy mind in a healthy body” principle.

Dr Ruscioblog.com says that due to the gut-brain connection, a healthy diet is key for cognitive function. Research shows that avoiding sugar, processed foods, and other foods that increase inflammation can make a significant difference in brain health. Diet, lifestyle, and gut health are foundational areas for supporting healthy brain function.

The last two factors, social interaction and challenging the brain, involve cognition more directly. Cognitive health is a crucial component to overall vitality, wellbeing, and quality of life. 

Maybe you are healthy, but you’re looking to take your cognitive health to the next level, or perhaps you struggle with memory issues, focus, or brain fog. Whatever your motivation, plenty of strategies can help you get to optimal brain function.

You can do plenty of things to improve cognitive function, regardless of your age and health status. Regularly exercising and stretching your brain capability at all ages and stages of life is well recognised across the world as key to keeping your brain healthy.

Research shows the best way to build cognitive reserve is, to be enrolled in and regularly attend structured education in early life, when our brains are more plastic. Cognitive ability can plateau in late adolescence, with education after the age of 20 having a smaller effect on building cognitive reserve. A 2019 study of 374,000 people in Pakistan showed that childhood literacy and school attendance are crucial to improve quality of life throughout individuals’ lives, inclusive of reducing the risk of developing dementia in older age.

Many adults seek to keep their brain exercised and stretched by doing daily puzzles such as sudoku, crosswords, wordle, jigsaw puzzles, etc. Research suggests once these become relatively quick and easy to solve, they are unlikely to be building much cognitive reserve. However regularly doing these activities is better than doing nothing, but ideally individuals continuously build the difficulty level of their chosen daily puzzle/s.     

One activity with strong indicators that it builds cognitive reserve, is speaking more than one language from childhood. However, learning a new language in older age is highly recommended for strengthening brain health.  When you can speak two or more languages your brain is constantly having to resist interference from the language not currently being used, this builds cognitive reserve and keeps it primed.

Thomas Bak, Cognitive Neuroscientist (University of Edinburgh) says, “language, like music stimulates a lot of cognitive functions involving sounds, form, concepts, grammar – and social interaction. And, in terms of the cognitive benefits, activities that are multilayered are much better than doing just one thing.”                  

Alzheimers Disease International (ADI), the global voice on dementia, in their World Alzheimers Report (2023) state “activities that stretch the brain, involve social interaction, and include aerobic activity seem the most effective in safeguarding brain health and keeping the body healthy too”. They cite a 2003 study in the Bronx, New York City, USA that looked into leisure activities and the risk of dementia in older people, it concluded “dancing was the only physical activity associated with a lower risk of dementia.” (Vergese J., Lipton Richard. B.,et al., “Leisure Activities and the risk of dementia in the elderly” cited in ADI Report, 2023, Chapter 2, Pg 34).             

It is still unclear what the exact ‘recipe’ is. The evidence from studies of large population groups suggests a strong correlation, with exposure at any age to the experiences and activities that stimulate curiosity, problem solving, and social interaction to build cognitive reserve. As yet we do not know the exact combination of factors, volume and frequency thereof, required to slow the rate of cognitive decline, and/or to reduce the risk of dementia. The growing body of research is proving that a ‘healthy mind in a healthy body’ or ‘mens sana in corpore sano,’ being the famous maxim coined by Roman poet Juvenal almost 2,000 years ago; remains increasingly more relevant at every age and stage of life, and inclusive of older age which is defined as 65+ years in Aotearoa New Zealand.   

Multiple studies are underway across the world to identify the ‘essential ingredients for the recipe’ for cognitive health across one’s lifespan. BRNZ (Brain Research New Zealand led by University of Auckland) has the eyes of the world on its study into biomarkers (biological signs of disease) to enable identification of which people are on the cusp of significant brain dysfunction. This will allow clinicians to deliver current treatments more effectively, before major brain damage has occurred; and also, will provide essential building blocks for further research into how to prevent diseases of the brain such as dementia. For more information https://www.brainresearch.co.nz/our-research/biomarkers-and-diagnosis

Rates of vascular dementia (damaged blood vessels causing reduced blood supply for brain functions) are increasing exponentially across the world.  Another world leading research study being led out of New Zealand is by Professor Julian Paton from the University of Auckland’s Faculty of Medical and Health Sciences. His Team is researching high blood pressure, which is the biggest risk factor for cardiovascular disease (blood vessel disease), and it is the leading cause of death across the world. A strong focus of his research is the correlation of high blood pressure with dementia in later life.  For more information find the interview with Dr Julian Paton titled: Blood pressure and links to dementia- find at: 

Julian Paton: Blood pressure and links to dementia | RNZ (search on the website of Radio NZ National, select programmes, then select Sunday mornings, then select Episodes and scroll down to 12 November 2023, and click on the name Julian Paton and click on the arrow to hear the interview).

In the interim, current evidence suggests that the earlier we start building our cognitive reserve, the better, but we can develop some cognitive reserve in later life. So, it is never too early or too late to start, and the more activities, the better: the effect appears to be cumulative.

An important action for older people is to encourage their children, grandchildren and great grandchildren to be enrolled in and regularly attend pre-school, primary school, intermediate school, secondary school, and actively participate in career learning within their first 20 years of life. This will constantly exercise and stretch their brains while they are at their most plastic and assist to lay down strong cognitive reserve for their adult and older age years ahead.      

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Date Published.  February 2024

To be reviewed: February 2027