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Review
. 2019 Mar 11;11(1):22.
doi: 10.1186/s13195-019-0479-y.

Concepts for brain aging: resistance, resilience, reserve, and compensation

Thomas J Montine  1 , Brenna A Cholerton  1 , Maria M Corrada  2 , Steven D Edland  3   4 , Margaret E Flanagan  5 , Laura S Hemmy  6 , Claudia H Kawas  2 , Lon R White  7
Affiliations
Review

Concepts for brain aging: resistance, resilience, reserve, and compensation

Thomas J Montine et al. Alzheimers Res Ther. .

Abstract

A primary goal of research in cognitive impairment and dementia is to understand how some individuals retain sufficient cognitive function for a fulfilling life while many others are robbed of their independence, sometimes their essence, in the last years and decades of life. In this commentary, we propose operational definitions of the types of factors that may help individuals retain cognitive function with aging. We propose operational definitions of resistance, resilience, reserve, with an eye toward how these may be measured and interpreted, and how they may enable research aimed at prevention. With operational definitions and quantification of resistance, resilience, and reserve, a focused analytic search for their determinants and correlates can be undertaken. This approach, essentially a search to identify protective risk factors and their mechanisms, represents a relatively unexplored pathway toward the identification of candidate preventive interventions.

Keywords: Alzheimer’s disease; Reserve capacity; Resilience; Resistance.

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Conflict of interest statement

Ethics approval and consent to participate

Table 1 data are from a previous publication in Neurology [1]. The Nun Study (NS) was reviewed and approved by Universities of Kentucky and Minnesota institutional review boards (IRBs). Participating School Sisters of Notre Dame had agreed to autopsy prior to death, with final authorizations provided by the Provincial Leader. The Honolulu Asia Aging Study (HAAS) was reviewed and approved by the Kuakini Hospital IRB. A consent form was signed by participants at every cycle (12 from 1965 to 2012), including consent for use of information and materials for research purposes by researchers and their colleagues, including NIH- associated, with no ending of this permission. HAAS autopsy acquisition procedure required notification of a participant’s death by family member, hospital, medical examiner’s office, or other source, with permission for autopsy and research use of information provided by next of kin.

Consent for publication

Not applicable.

Competing interests

SE serves on clinical trial Data Safety and Monitoring Boards for Eli Lilly and Suven Life Sciences. The other authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Relationships among adverse (red), protective (blue), and mixed (purple) processes that culminate in signs and symptoms of neurodegenerative diseases
See this image and copyright information in PMC

References

    1. White LR, Edland SD, Hemmy LS, Montine KS, Zarow C, Sonnen JA, et al. Neuropathologic comorbidity and cognitive impairment in the Nun and Honolulu-Asia Aging Studies. Neurol. 2016;86(11):1000–1008. doi: 10.1212/WNL.0000000000002480. - DOI - PMC - PubMed

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