Happy Thor’s Day! Let’s hammer this week home, what do ya say??? Things are starting to look up in the virus front. Folks are slowly but surely reopening and finding their niche in the new normal. Are things perfect? Even good? No…but they are getting better.
In today’s “class”, we will discuss cognitive reserve as it relates to the brain being a muscle. I realize I have kept some of this week’s material very vague. This is by necessity because it is deep stuff. The links will take you down the rabbit hole toward understanding this complex set of topics, so go as deep as you want.
So far we have concluded, to an extent, that there are smooth muscles that do things in the brain…therefore it is muscled. It isn’t “made of muscle”, but muscles play in extensively, mostly in the ridding our melons of the dreaded Beta Amyloid that are blamed somewhat for our topic. We posited the idea that the brain is “like a sponge” that these involuntary, smooth muscles push substances through. Some stuff is more likely to get clogged in the inner gaps between cells and the newly discovered IPAD areas and the flexing of muscles may partially help prevent this clogging.
So what of this “cognitive reserve”? Having a cognitive reserve means pretty much how it sounds…having more cognition ability/pathways than is necessary. It doesn’t mean having the “big head” (although some could be accused of such), but it can involve a physically bigger brain. Here is how Yaakov Stern, PhD of the NIH explains two types of cognitive reserve:
“The original concept of brain reserve was quantitative, for example more neurons or synapses to lose. This idea is supported by a set of studies that suggest that prevalence or incidence of dementia is lower in individuals with larger brains13, 14. I have suggested that this is a passive model of reserve, in that it suggests that the brain can simply tolerate more pathology before it reaches a critical threshold for clinical symptoms to appear.
In contrast, the concept of CR suggests that the brain actively attempts to cope with brain damage by using pre-existing cognitive processing approaches or by enlisting compensatory approaches15, 16. This would allow an individual with high CR to better cope with the brain damage than an individual with lower CR. In CR, brain function rather than brain size is the relevant variable. Thus the CR concept is an active form of reserve in that, the same amount of brain damage or pathology will have different effects on different people, even when brain size is held constant.
Although the initial conception of brain reserve was entirely quantitative, recent evidence suggests that this concept is more nuanced. For example stimulating environments foster the growth of new neurons in the form of neurogenesis17–19, and upregulate BDNF20, which fosters neural plasticity. Still, while in some ways interdependent, brain reserve and CR make independent in addition to synergistic contributions to understanding individual differences in clinical resilience to brain pathology. It is still an unresolved issue whether and how these two components of reserve interact.
Reserve was initially posited as a moderator between brain change and clinical outcome, but there are recent suggestions that life experience may also act to prevent or minimize pathology. On a simple level, it has always been recognized that exercise may serve to help prevent vascular disease. However, there are suggestions that cognitively stimulating activities may slow the rate of hippocampal atrophy in normal aging21, and perhaps even prevent accumulation of amyloid plaque22. While these ideas are promising and intriguing, they are beyond the scope of the current review, which will be limited to how CR may help cope with brain changes once they develop.”
Source (Note: emphases are mine)
Such an interesting topic. I wish I had unlimited time to unpack it for my own self-study and for your benefit as well, but life is too busy right now.
Allow me to try to create a word picture:
Think of the cognition/thinking as a well on a desert island. In order to think, work out problems, and function in activities of daily living (ADLs), needless to say in order thrive, you need to dip some thinkin’ water out of this well. You have some issues too:
- The water is, say, 1000′ deep.
- You only have the proverbial old bucket on a rope, and the bucket ain’t lookin’ too hot.
- You need this water FAST and OFTEN! Time is ticking. As it sits right now, you could run out of water and dehydrate if you don’t keep drawing from the well.
What you are trying to do to stay “hydrated” right now is using the rope and bucket method. It is working, but you are wearing out. There are some holes in the bucket and, as you crank your water bucket lifting crank, water drips from the bucket. It used to be that the bucket would give you a full gallon by the time you cranked it from its earthen destination, but now, in late life, the bucket only gives you just over a pint. It takes a pint to function at a very basic level…to keep the heart beating and basic functioning going. If there was only something that could have been done years ago, when you were first stuck on this island with your soccer ball, that would have prevented this problem.
OK…change the scenario. The day you were stuck on the desert island, you found a genie bottle whose resident offered you ONE WISH from a list of options that would make the situation better. (Note: work with me here…no wishing for removal from the desert island or even more wishes). You and the genie know that lack of water would kill you before other things would, so you act. Your two choices:
- Replace your well crank so you could get the bucket up faster
- Get a bigger and better bucket
Enter our discussion of the brain as a muscle. If we are to prevent dementia, we need to do the other stuff we always talk about. We need to have a heart/brain-healthy diet and we need to exercise. Those are givens as needs although not a guarantee. So, how would/does brain exercises such as a second language, music, art, etc… work within my little silly well analogy? Could it be that expanding the cognitive reserve would be cranking faster? getting a bigger bucket? Or does it just fill the water up closer and closer to the top of thee well. I expect, unless I am not understanding the concept correctly, it is the latter. If the water is now just 200 foot from the top instead of 1000 foot, you wouldn’t lose as much water as you cranked because it would be to the top faster.
Cognitive reserve makes you more resilient. That is HUGE! It is a variable we can sort of control. Our bucket is leaking when we are prone to dementia through the risk factors, but if brain exercise does something akin to raising our water level, we need to consider it. The problem lies in the IF. The jury is still somewhat out. I wish I could promise it, but I can’t. My mom did many of the things that build cognitive reserve, but may have started too late…or it may have delayed the onset more than we know…. Here are some links to self-study and comment:
There are other amazing benefits of strengthening our cognitive reserve as well:
This is a useful look at cognitive reserve:
So, how do you increase your cognitive reserve? Multiple languages, advanced/lifelong learning seem to be the best way to advance this cause although music and the arts make a strong case as well. Your typical brain games, in some cases, could move the needle some, but they have also been proven to just make you a better brain game player. It seems that we need a more broad brain exercise than they provide…one that requires more and diverse brain activities like the others. Interesting topic and it will be very interesting to see how this advances.
One more note: If the cognitive reserve facets of the disease are true, and every single sign points that way that I have read so far, it will set up a kind of a Synapse Gap between typically wealthier (who tend to have a higher education and more interest in the arts/music) and less affluent populations. This, to me, is a very compelling reason to add to the list to never cut funding in public schools to these programs, but increase them instead. It may be a public health consideration more than we know.
A final lament before wrapping this up: Mom did so much right….and still got the disease. I want to give each and every one of my co-teachers here (that is you…I learn more from you than you do from me) a silver bullet that, if will just do X, dementia will never come. I am sorry…flex your brain all you can for 1,000 reasons, but you may still get the disease. That is why a cure is our top priority. Until there is a cure, we will advocate, we will pray, we will serve, and we will keep on fighting to #EndALZ !
Update: Nothing new to report. I can’t go see her, nor even call this week. It is hard. 🙁