Cognitive reserve and the risk for Alzheimer's disease: a longitudinal study

Laura Serra, Massimo Musicco, Mara Cercignani, Mario Torso, Barbara Spanò, Chiara Mastropasqua, Giovanni Giulietti, Camillo Marra, Giuseppe Bruno, Giacomo Koch, Carlo Caltagirone, Marco Bozzali

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)


This study investigates how cognitive reserve (CR) interacts with neurodegeneration (quantified by medial temporal atrophy, MTA) and macroscopic white matter lesions (WMLs) in delaying the conversion from amnestic mild cognitive impairment to Alzheimer's disease (AD). Forty-two amnestic mild cognitive impairment patients were consecutively recruited. They underwent magnetic resonance imaging and a comprehensive questionnaire to classify them as individuals with low or high CR. Patients were then clinically followed-up for 2 years. The patients' risk for conversion to AD because of CR was estimated by controlling for cognitive efficiency, MTA, and WMLs at baseline. Global cognition was the best predictor of conversion to AD in low CR patients. Conversely, in high CR patients only, WMLs (but not MTA) highly contributed in increasing the risk for conversion to AD. In conclusion, CR interacts with both patients' cognitive features and WMLs in modulating the impact of AD pathology. This seems relevant for clinical prognosis and therapeutic strategies.
Original languageEnglish
Pages (from-to)N/A-N/A
JournalNeurobiology of Aging
Publication statusPublished - 2014


  • AD
  • Cognitive reserve
  • MTA
  • Relative risk
  • White matter lesions
  • a-MCI


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