Marie Stoner M.Ed., Clinical Psychologist & Chief Science Officer, Activate Brain and Body Holdings, Inc.
In the late 1980s, a Columbia University researcher named Yaakov Stern proposed the concept of Cognitive Reserve to explain how some people cope better than others with the same amount of damage to the brain. Stern reported on brain autopsies of normally functioning older people, showing 25% of elders whose neuropsychological testing was unimpaired prior to death met full pathological criteria for Alzheimer’s disease, meaning their brains had significant plaques and tangles. As drug companies have discovered after billions of dollars of failed research, it’s not just about the plaques and tangles.
The modern concept of Cognitive Reserve refers to the strength and/or more flexibility of neural networks that have the potential to explain the difference in individual susceptibility to decline, whether from aging or disease. With Cognitive Reserve, the brain can withstand more damage before crossing the line of functional impairment to clinical diagnosis. The personal and societal implications of Cognitive Reserve are enormous. Everyone wants to stay as functional as possible for as long as possible. And families want as much extra time with their loved ones as possible. For society, even a 1-year delay in symptom onset would result in 11.8 million fewer diagnoses worldwide by 2050.