Study on Cognitive Reserve in Korea Using Korean Version of Cognitive Reserve Index Questionnaire

Chi Hyun Choi; Soowon Park; Hyeon-Ju Park; Youngsung Cho; Bo Kyung Sohn; Jun-Young Lee

doi:10.4306/jknpa.2016.55.3.256

Journal List > J Korean Neuropsychiatr Assoc > v.55(3) > 1017807

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Choi, Park, Park, Cho, Sohn, and Lee: Study on Cognitive Reserve in Korea Using Korean Version of Cognitive Reserve Index Questionnaire

Original Article

Journal of Korean Neuropsychiatric Association 2016; 55(3): 256-263.

Published online: 31 August 2016

DOI: https://doi.org/10.4306/jknpa.2016.55.3.256

Study on Cognitive Reserve in Korea Using Korean Version of Cognitive Reserve Index Questionnaire

Chi Hyun Choi, MD¹, Soowon Park, PhD^2,³, Hyeon-Ju Park, MA³, Youngsung Cho, MD^3,⁴, Bo Kyung Sohn, MD³, Jun-Young Lee, MD, PhD^3,⁴

¹Department of Psychiatry, Seoul National University Hospital, Seoul, Korea.

²Department of Education, Seoul National University, Seoul, Korea.

³Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Korea.

⁴Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Korea.

Address for correspondence: Jun-Young Lee, MD, PhD. Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea. Tel +82-2-870-2462 Fax +82-2-6280-6099 benji@snu.ac.kr

Received 27 April 2016 Revised 8 June 2016 Accepted 22 July 2016

Abstract

Objectives

To evaluate cognitive reserve in Korea using Korean version of Cognitive Reserve Index questionnaire (K-CRIq) and to investigate the effects of gender and age on cognitive reserve.

Methods

Three hundred and fifty-eight healthy subjects aged 25–85 years old in one community participated in the study. K-CRIq was developed and administered to all subjects to assess the effects of gender and age on cognitive reserve. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were administered to subjects over 65 years old to test concurrent validity.

Results

Age and gender as well as their interaction significantly affected Cognitive Reserve Index (CRI) score. Men had higher cognitive reserve than women over 45 years old, but at younger ages there was no gender difference in cognitive reserve. CRI score and sub-scores were strongly associated with the MMSE and MoCA.

Conclusion

The results indicate that the gender effect on cognitive reserve is disappearing in the young generation in Korea. Scores in neuropsychological tests are predicted well by the CRI score.

Keywords: Cognitive reserve, Aging, Gender

Figures and Tables

Fig. 1

Scatter-plots and regression lines of raw scores of CRI-education, CRI-working activity, and CRI-leisure time. CRI : Cognitive Reserve Index.

Fig. 2

Barplots displaying the means (with corresponding standard errors) of CRI and sub-scores in gender and age groups. ^* : p<0.05, ^† : p<0.001. CRI : Cognitive Reserve Index.

Table 1

Means and standard deviations of CRI and sub-scores across gender and age

CRI : Cognitive Reserve Index

Table 2

Pearson correlation coefficients(r) between CRI, CRI-education, CRI-working activity, CRI-leisure time, and neuropsychological tests

^* : p<0.001. CRI : Cognitive Reserve Index, MMSE-DS : Korean version of Mini Mental Status Examination for Dementia Screening, MoCA-K : Korean version of the Montreal Cognitive Assessment

Notes

^{Conflicts of Interest} The authors have no financial conflicts of interest.

References

1. Katzman R, Terry R, DeTeresa R, Brown T, Davies P, Fuld P, et al. Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques. Ann Neurol. 1988; 23:138–144.

2. Stern Y. What is cognitive reserve? Theory and research application of the reserve concept. J Int Neuropsychol Soc. 2002; 8:448–460.

3. Stern Y. Cognitive reserve. Neuropsychologia. 2009; 47:2015–2028.

4. Stern Y. Cognitive reserve in ageing and Alzheimer's disease. Lancet Neurol. 2012; 11:1006–1012.

5. Valenzuela MJ, Sachdev P. Brain reserve and dementia: a systematic review. Psychol Med. 2006; 36:441–454.

6. Valenzuela MJ, Sachdev P. Assessment of complex mental activity across the lifespan: development of the Lifetime of Experiences Questionnaire (LEQ). Psychol Med. 2007; 37:1015–1025.

7. Rami L, Valls-Pedret C, Bartrés-Faz D, Caprile C, Solé-Padullés C, Castellvi M, et al. [Cognitive reserve questionnaire. Scores obtained in a healthy elderly population and in one with Alzheimer's disease]. Rev Neurol. 2011; 52:195–201.

8. Leon I, Garcia J, Roldan-Tapia L. [Development of the scale of cognitive reserve in Spanish population: a pilot study]. Rev Neurol. 2011; 52:653–660.

9. Nucci M, Mapelli D, Mondini S. Cognitive Reserve Index questionnaire (CRIq): a new instrument for measuring cognitive reserve. Aging Clin Exp Res. 2012; 24:218–226.

10. Nithianantharajah J, Hannan AJ. Enriched environments, experiencedependent plasticity and disorders of the nervous system. Nat Rev Neurosci. 2006; 7:697–709.

11. Alzheimer's Association. 2015 Alzheimer's disease facts and figures. Alzheimers Dement. 2015; 11:332–384.

12. Seshadri S, Wolf PA, Beiser A, Au R, McNulty K, White R, et al. Lifetime risk of dementia and Alzheimer’s disease. The impact of mortality on risk estimates in the Framingham Study. Neurology. 1997; 49:1498–1504.

13. Hebert LE, Scherr PA, McCann JJ, Beckett LA, Evans DA. Is the risk of developing Alzheimer's disease greater for women than for men? Am J Epidemiol. 2001; 153:132–136.

14. Gao S, Hendrie HC, Hall KS, Hui S. The relationships between age, sex, and the incidence of dementia and Alzheimer disease: a meta-analysis. Arch Gen Psychiatry. 1998; 55:809–815.

15. Andersen K, Launer LJ, Dewey ME, Letenneur L, Ott A, Copeland JR, et al. Gender differences in the incidence of AD and vascular dementia: The EURODEM Studies. EURODEM Incidence Research Group. Neurology. 1999; 53:1992–1997.

16. Edland SD, Rocca WA, Petersen RC, Cha RH, Kokmen E. Dementia and Alzheimer disease incidence rates do not vary by sex in Rochester, Minn. Arch Neurol. 2002; 59:1589–1593.

17. Prince M, Acosta D, Ferri CP, Guerra M, Huang Y, Llibre Rodriguez JJ, et al. Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: a 10/66 Dementia Research Group population-based cohort study. Lancet. 2012; 380:50–58.

18. Musicco M. Gender differences in the occurrence of Alzheimer's disease. Funct Neurol. 2009; 24:89–92.

19. Mielke MM, Vemuri P, Rocca WA. Clinical epidemiology of Alzheimer’s disease: assessing sex and gender differences. Clin Epidemiol. 2014; 6:37–48.

20. Rocca WA, Mielke MM, Vemuri P, Miller VM. Sex and gender differences in the causes of dementia: a narrative review. Maturitas. 2014; 79:196–201.

21. Ruitenberg A, Ott A, van Swieten JC, Hofman A, Breteler MM. Incidence of dementia: does gender make a difference? Neurobiol Aging. 2001; 22:575–580.

22. Opdebeeck C, Martyr A, Clare L. Cognitive reserve and cognitive function in healthy older people: a meta-analysis. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2016; 23:40–60.

23. Kim TH, Jhoo JH, Park JH, Kim JL, Ryu SH, Moon SW, et al. Korean version of Mini Mental Status Examination for Dementia Screening and its' short form. Psychiatry Investig. 2010; 7:102–108.

24. Lee JY, Lee DW, Cho SJ, Na DL, Jeon HJ, Kim SK, et al. Brief screening for mild cognitive impairment in elderly outpatient clinic: validation of the Korean version of the Montreal Cognitive Assessment. J Geriatr Psychiatry Neurol. 2008; 21:104–110.

25. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12:189–198.

26. Kwon YC, Park JH. Korean version of Mini-Mental State Examination (MMSE-K): part I. Development of the test for the elderly. J Korean Neuropsychiatr Assoc. 1989; 28:125–135.

27. Kang Y, Na DL, Hahn S. A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients. J Korean Neurol Assoc. 1997; 15:300–308.

28. Lee JH, Lee KU, Lee DY, Kim KW, Jhoo JH, Kim JH, et al. Development of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K): clinical and neuropsychological assessment batteries. J Gerontol B Psychol Sci Soc Sci. 2002; 57:P47–P53.

29. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005; 53:695–699.

30. Lee JY, Chang SM, Jang HS, Chang JS, Suh GH, Jung HY, et al. Illiteracy and the incidence of Alzheimer's disease in the Yonchon County survey, Korea. Int Psychogeriatr. 2008; 20:976–985.

31. Bae JB, Kim YJ, Han JW, Kim TH, Park JH, Lee SB, et al. Incidence of and risk factors for Alzheimer's disease and mild cognitive impairment in Korean elderly. Dement Geriatr Cogn Disord. 2015; 39:105–115.

32. O'Connor DW, Pollitt PA, Treasure FP, Brook CP, Reiss BB. The influence of education, social class and sex on Mini-Mental State scores. Psychol Med. 1989; 19:771–776.

33. Crum RM, Anthony JC, Bassett SS, Folstein MF. Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA. 1993; 269:2386–2391.

34. Zadikoff C, Fox SH, Tang-Wai DF, Thomsen T, de Bie RM, Wadia P, et al. A comparison of the mini mental state exam to the Montreal cognitive assessment in identifying cognitive deficits in Parkinson's disease. Mov Disord. 2008; 23:297–299.

35. Schooler C, Mulatu MS, Oates G. Occupational self-direction, intellectual functioning, and self-directed orientation in older workers: findings and implications for individuals and societies. Am J Soc. 2004; 110:161–197.

36. Scarmeas N, Stern Y. Cognitive reserve: implications for diagnosis and prevention of Alzheimer's disease. Curr Neurol Neurosci Rep. 2004; 4:374–380.

37. Baldivia B, Andrade VM, Amodeo Bueno OF. Contribution of education, occupation and cognitively stimulating activities to the formation of cognitive reserve. Dement Neuropsychol. 2008; 2:173–182.

38. Ghaffar O, Fiati M, Feinstein A. Occupational attainment as a marker of cognitive reserve in multiple sclerosis. PLoS One. 2012; 7:e47206.

TOOLS

Similar articles

Study on Cognitive Reserve in Korea Using Korean Version of Cognitive Reserve Index Questionnaire

Abstract

Objectives

Methods

Results

Conclusion

Figures and Tables

Fig. 1

Scatter-plots and regression lines of raw scores of CRI-education, CRI-working activity, and CRI-leisure time. CRI : Cognitive Reserve Index.

Fig. 2

Barplots displaying the means (with corresponding standard errors) of CRI and sub-scores in gender and age groups. * : p<0.05, † : p<0.001. CRI : Cognitive Reserve Index.

Table 1

Means and standard deviations of CRI and sub-scores across gender and age

Table 2

Pearson correlation coefficients(r) between CRI, CRI-education, CRI-working activity, CRI-leisure time, and neuropsychological tests

Notes

References

Barplots displaying the means (with corresponding standard errors) of CRI and sub-scores in gender and age groups. ^* : p<0.05, ^† : p<0.001. CRI : Cognitive Reserve Index.