Cognitive resilience in ageing: determinants and interventions.

Abstract

Understanding the factors that contribute to the preservation of cognitive abilities into advanced age despite brain injury or disease is a key goal of ageing research. Up until the last two decades, the extent of brain pathology could only be fully appreciated at autopsy. Advances in laboratory and imaging biomarkers now mean that cognitive function can be understood in the context of markers of brain injury and specific pathologies (eg, Alzheimer's disease, Lewy body disease, and cerebrovascular disease). Knowledge on the characteristics of individuals displaying cognitive resilience and its social determinants across the lifespan can inform strategies to enhance resilience at individual and population levels. There is some evidence of the effectiveness of interventions to improve cognitive functioning from high-income countries, supported by biomarker data. Looking ahead, translation of cognitive resilience research to low-income and middle-income countries-the regions with the fastest growth in dementia burden-will require addressing key challenges and seizing opportunities.