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Brain reserve and dementia: a systematic review.

Abstract

BACKGROUND

Behavioural brain reserve is a property of the central nervous system related to sustained and complex mental activity which can lead to differential expression of brain injury. Behavioural brain reserve has been assessed using autobiographical data such as education levels, occupational complexity and mentally stimulating lifestyle pursuits. So far there have been several epidemiological reports but no systematic review to put conflicting results into context. Our aim was to quantitatively review evidence for the effect of brain reserve on incident dementia.

METHOD

Cohort studies of the effects of education, occupation, premorbid IQ and mental activities on dementia risk were of interest. Abstracts were identified in MEDLINE (1966-September 2004), CURRENT CONTENTS (to September, 2004), PsychINFO (1984-September 2004), Cochrane Library Databases and reference lists from relevant articles. Twenty-two studies met inclusion criteria. Key information was extracted by both reviewers onto a standard template with a high level of agreement. Studies were combined through a quantitative random-effects meta-analysis.

RESULTS

Higher brain reserve was associated with a lowered risk for incident dementia (summary odds ratio, 0.54; 95% confidence interval, 0.49-0.59). This effect was found over a median of 7.1 years follow-up and resulted from integrating data across more than 29000 individuals. Notably, increased complex mental activity in late life was associated with lower dementia rates independent of other predictors; a dose-response relationship was also evident between extent of complex mental activities in late life and dementia risk.

CONCLUSIONS

This study demonstrates robust evidence that complex patterns of mental activity in the early, mid- and late-life stages is associated with a significant reduction in dementia incidence. Randomized control trials based on brain-reserve principles are now required.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    The Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia. michael@dancenetwork.com.au

    Source

    Psychological medicine 36:4 2006 Apr pg 441-54

    MeSH

    Brain
    Dementia
    Humans
    Leisure Activities
    Public Health

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    16207391

    Citation

    Valenzuela, Michael J., and Perminder Sachdev. "Brain Reserve and Dementia: a Systematic Review." Psychological Medicine, vol. 36, no. 4, 2006, pp. 441-54.
    Valenzuela MJ, Sachdev P. Brain reserve and dementia: a systematic review. Psychol Med. 2006;36(4):441-54.
    Valenzuela, M. J., & Sachdev, P. (2006). Brain reserve and dementia: a systematic review. Psychological Medicine, 36(4), pp. 441-54.
    Valenzuela MJ, Sachdev P. Brain Reserve and Dementia: a Systematic Review. Psychol Med. 2006;36(4):441-54. PubMed PMID: 16207391.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Brain reserve and dementia: a systematic review. AU - Valenzuela,Michael J, AU - Sachdev,Perminder, Y1 - 2005/10/06/ PY - 2005/10/7/pubmed PY - 2006/8/4/medline PY - 2005/10/7/entrez SP - 441 EP - 54 JF - Psychological medicine JO - Psychol Med VL - 36 IS - 4 N2 - BACKGROUND: Behavioural brain reserve is a property of the central nervous system related to sustained and complex mental activity which can lead to differential expression of brain injury. Behavioural brain reserve has been assessed using autobiographical data such as education levels, occupational complexity and mentally stimulating lifestyle pursuits. So far there have been several epidemiological reports but no systematic review to put conflicting results into context. Our aim was to quantitatively review evidence for the effect of brain reserve on incident dementia. METHOD: Cohort studies of the effects of education, occupation, premorbid IQ and mental activities on dementia risk were of interest. Abstracts were identified in MEDLINE (1966-September 2004), CURRENT CONTENTS (to September, 2004), PsychINFO (1984-September 2004), Cochrane Library Databases and reference lists from relevant articles. Twenty-two studies met inclusion criteria. Key information was extracted by both reviewers onto a standard template with a high level of agreement. Studies were combined through a quantitative random-effects meta-analysis. RESULTS: Higher brain reserve was associated with a lowered risk for incident dementia (summary odds ratio, 0.54; 95% confidence interval, 0.49-0.59). This effect was found over a median of 7.1 years follow-up and resulted from integrating data across more than 29000 individuals. Notably, increased complex mental activity in late life was associated with lower dementia rates independent of other predictors; a dose-response relationship was also evident between extent of complex mental activities in late life and dementia risk. CONCLUSIONS: This study demonstrates robust evidence that complex patterns of mental activity in the early, mid- and late-life stages is associated with a significant reduction in dementia incidence. Randomized control trials based on brain-reserve principles are now required. SN - 0033-2917 UR - https://www.unboundmedicine.com/medline/citation/16207391/Brain_reserve_and_dementia:_a_systematic_review_ L2 - https://www.cambridge.org/core/product/identifier/S0033291705006264/type/journal_article DB - PRIME DP - Unbound Medicine ER -