White matter hyperintensities and cognition: Testing the reserve hypothesis

Adam M. Brickman, Karen L. Siedlecki, Jordan Muraskin, Jennifer J. Manly, José A. Luchsinger, Lok Kin Yeung, Truman R. Brown, Charles DeCarli, Yaakov Stern

Research output: Contribution to journalArticle

136 Citations (Scopus)

Abstract

Objective: White matter hyperintensities (WMH), visualized on T2-weighted MRI, are thought to reflect small-vessel vascular disease. Much like other markers of brain disease, the association between WMH and cognition is imperfect. The concept of reserve may account for this imperfect relationship. The purpose of this study was to test the reserve hypothesis in the association between WMH severity and cognition. We hypothesized that individuals with higher amounts of reserve would be able to tolerate greater amounts of pathology than those with lower reserve. Methods: Neurologically healthy older adults (n= 717) from a community-based study received structural MRI, neuropsychological assessment, and evaluation of reserve. WMH volume was quantified algorithmically. We derived latent constructs representing four neuropsychological domains, a measure of cognitive reserve, and a measure of brain reserve. Measures of cognitive and brain reserve consisted of psychosocial (e.g., education) and anthropometric (e.g., craniometry) variables, respectively. Results: Increased WMH volume was associated with poorer cognition and higher cognitive and brain reserve were associated with better cognition. Controlling for speed/executive function or for language function, those with higher estimates of cognitive reserve had significantly greater degrees of WMH volume, particularly among women. Controlling for cognitive functioning across all domains, individuals with higher estimates of brain reserve had significantly greater WMH volume. Conclusions: For any given level of cognitive function, those with higher reserve had more pathology in the form of WMH, suggesting that they are better able to cope with pathology than those with lower reserve. Both brain reserve and cognitive reserve appear to mitigate the impact of pathology on cognition.

Original languageEnglish (US)
Pages (from-to)1588-1598
Number of pages11
JournalNeurobiology of Aging
Volume32
Issue number9
DOIs
StatePublished - Sep 2011

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Cognitive Reserve
Cognition
Pathology
Cephalometry
White Matter
Executive Function
Brain Diseases
Vascular Diseases
Language

Keywords

  • Aging
  • Cognition
  • Cognitive reserve
  • MRI
  • White matter hyperintensities

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)
  • Aging
  • Developmental Biology
  • Geriatrics and Gerontology

Cite this

Brickman, A. M., Siedlecki, K. L., Muraskin, J., Manly, J. J., Luchsinger, J. A., Yeung, L. K., ... Stern, Y. (2011). White matter hyperintensities and cognition: Testing the reserve hypothesis. Neurobiology of Aging, 32(9), 1588-1598. https://doi.org/10.1016/j.neurobiolaging.2009.10.013

White matter hyperintensities and cognition : Testing the reserve hypothesis. / Brickman, Adam M.; Siedlecki, Karen L.; Muraskin, Jordan; Manly, Jennifer J.; Luchsinger, José A.; Yeung, Lok Kin; Brown, Truman R.; DeCarli, Charles; Stern, Yaakov.

In: Neurobiology of Aging, Vol. 32, No. 9, 09.2011, p. 1588-1598.

Research output: Contribution to journalArticle

Brickman, AM, Siedlecki, KL, Muraskin, J, Manly, JJ, Luchsinger, JA, Yeung, LK, Brown, TR, DeCarli, C & Stern, Y 2011, 'White matter hyperintensities and cognition: Testing the reserve hypothesis', Neurobiology of Aging, vol. 32, no. 9, pp. 1588-1598. https://doi.org/10.1016/j.neurobiolaging.2009.10.013
Brickman AM, Siedlecki KL, Muraskin J, Manly JJ, Luchsinger JA, Yeung LK et al. White matter hyperintensities and cognition: Testing the reserve hypothesis. Neurobiology of Aging. 2011 Sep;32(9):1588-1598. https://doi.org/10.1016/j.neurobiolaging.2009.10.013
Brickman, Adam M. ; Siedlecki, Karen L. ; Muraskin, Jordan ; Manly, Jennifer J. ; Luchsinger, José A. ; Yeung, Lok Kin ; Brown, Truman R. ; DeCarli, Charles ; Stern, Yaakov. / White matter hyperintensities and cognition : Testing the reserve hypothesis. In: Neurobiology of Aging. 2011 ; Vol. 32, No. 9. pp. 1588-1598.
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