• What is memory?
  • Short-term memory
  • Long-term memory
  • Declarative memory
  • Procedural memory
• How we remember
  • As good as memories in the bank
  • Stage one: Acquisition.
  • Stage two: Consolidation
  • Stage three: Retrieval
• Forgetting: What’s normal?
  • Seven types of normal memory problems
• How memory changes with age
  • Why memory fades
  • When brain cells die
  • Growing new brain cells
• Memory impairment: Normal aging or brain disease?
  • Mild cognitive impairment.
  • Dementia
• Health and lifestyle factors linked to memory problems
  • Obesity
  • Cardiovascular disease and its risk factors
  • Diabetes
  • Depression
  • Hearing loss
  • Hormones
  • Medications
  • Lifestyle factors
• Special bonus section: Nine steps to an optimal memory
• Improving everyday memory
  • Organizational tools
  • Behavioral strategies
  • Memory-enhancing techniques
  • Professional memory training
• When to see a doctor
  • The first step
  • Neuropsychological testing
  • Brain-imaging tests
• Medications for memory impairment
• Resources
• Glossary

Cognitive reserve: Engage your brain

Scientists have long wondered why Alzheimer’s disease doesn’t affect all people in the same way. In two people who have the same number of disease-related plaques and tangles—evidence of structural damage—one may continue to function normally while the other suffers severe memory impairment. The answer to this conundrum seems to lie in what experts refer to as “cognitive reserve.” Generally speaking, this term describes the capacity of the brain to use alternative neural pathways or thinking strategies in response to damage from disease or injury. There are two aspects to this protective mechanism. The first, called brain reserve capacity is the number of neurons and synapses a person’s brain has. The theory is that a person who has more brain “hardware” to fall back on is able to maintain cognitive functions even when some of the structures are damaged. The other element, cognitive reserve, refers to the degree of efficiency and flexibility the brain has in processing information. People whose brains have alternate networks or cognitive strategies at their disposal are less likely to experience disruption in their mental processes in the face of disease.

There are numerous factors that can reduce brain reserve capacity, including cerebrovascular disease, strokes, injury, and toxins. You need to treat your brain with the care and respect that it deserves. Although there may be little you can do to improve your brain reserve capacity, which in large part is genetically determined, there is evidence that exercise, cognitive stimulation, and training can alter brain structure. In fact, MRI scans of people learning to juggle show increases in the size of brain structures linked with the visual processing of movement compared with scans of control subjects. Likewise, the MRIs of London taxi drivers reveal larger volumes in the posterior hippocampus (an area thought to control spatial memory) compared with controls.

Although formal educational achievement is an important factor, virtually any activity that stretches your brain can bolster your cognitive reserve. Granted, it’s hard to determine cause and effect, since older individuals who don’t participate in cognitively stimulating activities may be manifesting the early effects of a neurodegenerative disease. However, this possibility cannot explain the results of other research that has found that people who engage their brains in their leisure time in middle age have a lower risk of developing dementia many decades later. The take-away message is this: engaging your brain with intellectually stimulating activities will afford your brain greater protection down the road. Building your cognitive reserve is an ongoing process that should be pursued throughout life.

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I bought this report because I had worries about a family member. The report was so helpful because it let me understand what was normal and what was outside the norm. We decided to get help for our family member but there was side benefit--the tips for ways to improve memory were really helpful to me. Gratefully, Joan S

I read the report and was hoping to find something that help hope for a family member. It appears that the research has not progressed to the point that traditional medicine can offer something positive. It is too bad that alternative medicine has not been respected enough to receive support from the larger medical profession, particularly in cases where traditional medicine is still stumped. I have found more hope in the research from alternative (natural) medicine, but the larger medical profession would prefer to stand still and do and offer nothing. It is all about money.

I found it informative. It reinforced what I have been doing. Perhaps if people followed the recommendations in the report we would have less mental problems.