Nicole D. Anderson

Nicole D. Anderson Ph.D., C.Psych.

Living With Mild Cognitive Impairment

Building Cognitive Reserve

It's never too late to build cognitive reserve

Posted Nov 27, 2015

So far in this blog, we have relayed evidence-based information about how to decrease your chances of developing MCI, or progressing from MCI to dementia. The three authors of this blog are not only consumers of this information; we also contribute to it through our scientific work. In this post, we want to share an exciting new study that we are about to launch, along with 17 other Canadian researchers, called Engage.

This study was motivated by two intriguing scientific findings. The first finding is that people who have led more cognitively stimulating lives  – through formal education, complex paid occupations, and/or cognitively engaging hobbies – have a reduced risk of developing dementia. The other striking finding is that some people are found to have a lot of Alzheimer’s pathology in their brain when they die, despite having no cognitive symptoms prior to their death, and this is more likely to occur in people who led cognitively stimulating lives. Together, these results suggest that cognitive engagement provides cognitive reserve that delays the onset of cognitive impairment, despite the fact that Alzheimer’s disease pathology may be accumulating in the brain.

The question we are asking in Engage is: Through programs that provide stimulating cognitive engagement, can we build cognitive reserve in older age? Engage combines formal cognitive training and leisure activities that stimulate cognition, such as learning music, learning a second language, learning new things in a ‘late-life education’ format, or playing video games that facilitate cognitive skills, such as attention and memory. Our hypothesis is that it’s never too late to build cognitive reserve. Specifically, we predict that combining formal cognitive training with more natural, engaging leisure activity will lead to improvements in memory and attention, psychosocial wellbeing, and brain functioning.

Glenda/Shutterstock
Source: Glenda/Shutterstock

Because the study is focused on prevention, we will be recruiting people who believe that they have cognitive difficulties, but these cognitive changes are not reflected in test scores. We chose to focus the study on this group, who experience subjective cognitive impairment as opposed to the objective cognitive impairment evident in those with MCI, because it has been identified as a risk factor for developing cognitive impairment. By no means do all cases of subjective cognitive impairment lead to dementia, but sometimes people are more sensitive to small cognitive changes that are too subtle for formal cognitive tests to detect.

We will examine both the short-term and long-term effects of Engage, and we will identify which factors contribute to better outcomes, such as age, gender, or genetic background, in order to help clinicians identify the right interventions for the right people.

The study will be run in Toronto, in English, and in Montreal, in French. To learn more about Engage, we welcome you to watch a short video and read a recent article, “How nun dodged Alzheimer’s part of dementia’s mystery” published in the Toronto Star newspaper.

Engage will run from 2016-2018, and we look forward to sharing the ways Canadians can build their cognitive reserve as a defence against dementia. If you live in the Toronto or Montreal area and would like to be part of Engage, please call Aline Moussard at 416-785-2500 x6156, or Céline Fouquet at 514-340-3540 x3633.

Engage is one of many studies coming out of the Canadian Consortium on Neurodegeneration in Aging (CCNA), which is a Government of Canada initiative, also supported by several national, provincial and industry partner organizations.