What is cognitive reserve? Theory and research application of the reserve concept
Tóm tắt
The idea of reserve against brain damage stems from the repeated
observation that there does not appear to be a direct relationship
between the degree of brain pathology or brain damage and the
clinical manifestation of that damage. This paper attempts to
develop a coherent theoretical account of reserve. One convenient
subdivision of reserve models revolves around whether they envision
reserve as a passive process, such as in brain reserve or
threshold, or see the brain as actively attempting to cope with
or compensate for pathology, as in cognitive reserve. Cognitive
reserve may be based on more efficient utilization of brain
networks or of enhanced ability to recruit alternate brain networks
as needed. A distinction is suggested between reserve, the ability
to optimize or maximize normal performance, and compensation,
an attempt to maximize performance in the face of brain damage
by using brain structures or networks not engaged when the brain
is not damaged. Epidemiologic and imaging data that help to
develop and support the concept of reserve are presented.
(