Effects of cognitive reserve on cognitive frailty among older adults: A population-based prospective cohort study

AimWe investigated the effect of lifespan cognitive reserve and its components on cognitive frailty among older adults.MethodsA total of 4922 participants aged >= 65 years were recruited in 2008 and were followed up in 2011 from the Chinese Longitudinal Healthy Longevity Survey. Cognitive frailty was determined through the simultaneous presence of physical frailty (pre-frailty or frailty) and mild cognitive impairment, excluding concurrent dementia. The assessment of physical frailty and mild cognitive impairment was based on the Fatigue, Resistence, Ambulation, Illness, Loss of weight (FRAIL) (Fatigue, Resistence, Ambulation, Illness, Loss) and Mini-Mental State Examination scale, respectively. The lifespan cognitive reserve consisted of education attainment, occupational complexity and later-life leisure activities. We used logistic regression models to estimate the risk of cognitive frailty associated with the lifespan cognitive reserve and its components.ResultsA higher level of lifespan cognitive reserve, higher educational attainment or leisure activities engagement, but not occupational complexity, were associated with lower risk of incident cognitive frailty. Furthermore, cognitive, social and physical activities were associated with lower risk of incident cognitive frailty.ConclusionCognitive reserve, particularly educational attainment and leisure activities, can protect from cognitive frailty. This implicates that individuals should accumulate cognitive reserve in their lifespan, and older adults should actively participate in leisure activities to prevent cognitive frailty. Geriatr Gerontol Int 2024; center dot center dot: center dot center dot-center dot center dot. Among older adults, cognitive reserve accumulated from various stages of the lifespan can protect from cognitive frailty. Educational attainment and leisure activities, the individual proxy of cognitive reserve, can protect from cognitive frailty. Older adults should actively participate in leisure activities in their later years to prevent cognitive frailty. image