By Richard Restak, MD, The George Washington University School of Medicine and Health Sciences

Edited by Kate Findley and proofread by Angela Shoemaker, The Great Courses Daily

Just like you can start a savings account for your finances, you can do the same thing with your brain. According to Dr. Restak, Alzheimer’s disease does not have to be inevitable.

Building Cognitive Reserve

Cognitive reserve is the ability to resist the brain damage that typically occurs with aging. Think of cognitive reserve as a metaphor for monetary reserve: The greater your monetary reserve, the more money you will have available to manage financial reverses in difficult economic times or after retirement.

Similarly, the more cognitive reserve you’ve built up over your lifetime, the less you will be affected by brain disease. People with higher cognitive reserve are better at recruiting alternative nerve cell networks or increasing the efficiency of existing networks in response to age-related changes.

Cognitive reserve is not something you are born with, but rather something you can modify throughout your lifespan. Think back to our monetary analogy: It’s never too late to start saving, but the earlier you start saving, the better. 

Resisting Brain Damage

A Scottish Mental Survey analyzed people born in 1921 who were IQ-tested at age 11 and many years later at age 80. Although the IQ scores at 11 were strong predictors of IQ at 80, some respondents significantly increased their IQ. 

The results indicate a crucial point: IQ can be increased. Additionally, a Swedish Twin Registry found that people engaged in complex occupations seemed to be protected against Alzheimer’s disease and other dementias.

Yaakov Stern of Columbia University has found that greater cognitive reserve is linked with greater activation in the frontal lobes. The frontal lobes are key to our most advanced brain functioning. 

If not stimulated, the frontal lobes function less well as we age. Anything that stimulates the frontal lobes contributes to cognitive reserve. 

Alzheimer’s Considerations

“I want you to keep two caveats in mind,” Dr. Restak said. “We want to be really reasonable here and think about the cognitive abilities.”

First, it’s possible that people with higher IQs to start with are drawn to activities that will increase their cognitive reserve. Some people with higher IQs may even get increased satisfaction from cognitive stimulation. 

Second, Alzheimer’s is a disease that’s strongly inherited. For example, Iris Murdoch was considered one of the greatest novelists of the 20^th century by many literary scholars as well as a philosopher. Still, she fell prey to the onslaught of Alzheimer’s and eventually died of that illness.

Super-Aging

Neuroscientists have recently come up with another surprising finding called super-aging. The brains of some elderly people lack tau tangle formation or have fewer tangles than are typically found in normal aging. 

Changiz Geula of the Super Aging Project of Northwestern University described nine people older than 80 who performed as well on memory tests as 50-year-olds. They could recall facts after hearing a story, plus a list of more than a dozen words. 

As part of the protocol, all study subjects agreed to donate their brains for examination after death. The goal is now to increase the number of participants from nine to 50. 

“What’s exciting about this is that it’s the first study ever with the focus on what is right with the brains of older people,” Dr. Restak said.

So far, we have no explanation for the super-aged. It could be environment, lifestyle, genetics, or perhaps a combination of all three. 

It’s best to assume it’s not all genetics since we have little control over that. We do remain in control of our lifestyle and environment. 

Super-aged people fall into two groups: Either their brains are almost immune to tangles or they have fewer tangles than most others of the same age. This has profound implications for our understanding of the aged brain. 

Perhaps degenerative changes are not inevitable. However, it’s better to assume you are one of the majority who will benefit from building up your cognitive reserve.

First Steps for Cognitive Health

First, start with things that you enjoy and excel at, but also work on things that don’t come so easily. Try new and unexpected things.

If you’re a lawyer, pursue math, physics, and geometry. If you’re a mathematician, get into literature, read novels, and understand history. 

The goal in whatever you do is to build the brain that you will want to live with for the rest of your life. To do that, you have to recognize your deficiencies, which is difficult for all of us. 

We all have ego problems to overcome. For example, you can ask any group of people how many of them consider themselves to be of greater than average intelligence. 

“I can almost guarantee that everyone will put their hand up to indicate yes,” Dr. Restak said. “Well, if that’s true, then the concept of average intelligence has no meaning.”

Thus, to build up your cognitive reserve, take on challenging projects and put your ego aside. Additionally, the projects must be individualized. If you are a competitive person, poker may be better for you than bridge, where team playing is important. 

If you retire, take on a hobby. Your goal is to keep your brain stimulated to increase cognitive reserve and resist brain damage. 

This article was edited by Kate Findley, Writer for The Great Courses Daily, and proofread by Angela Shoemaker, Proofreader and Copy Editor for The Great Courses Daily.

Dr. Richard Restak is Clinical Professor of Neurology at The George Washington University School of Medicine and Health Sciences. He earned his MD from Georgetown University School of Medicine. Professor Restak also maintains an active private practice in neurology and neuropsychiatry in Washington, D.C.