Mid- and late-life lifestyle activities as main drivers of general and domain-specific cognitive reserve in individuals with Parkinson’s disease: cross-sectional and longitudinal evidence from the LANDSCAPE study
Anja Ophey, Kathrin Wirtz, Steffen Wolfsgruber, Monika Balzer‐Geldsetzer, Daniela Berg, Rüdiger Hilker-Roggendorf, Jan Kassubek, Inga Liepelt‐Scarfone, Sara Becker, Britt Mollenhauer, Kathrin Reetz, Oliver Riedel, Jörg B. Schulz, Alexander Storch, Claudia Trenkwalder, Karsten Witt, Hans‐Ulrich Wïttchen, Richard Dodel, Sandra Roeske, Elke Kalbe
Abstract
BACKGROUND: Cognitive reserve (CR) is considered a protective factor for cognitive function and may explain interindividual differences of cognitive performance given similar levels of neurodegeneration, e.g., in Alzheimer´s disease. Recent evidence suggests that CR is also relevant in Parkinson's disease (PD). OBJECTIVE: We aimed to explore the role of life-stage specific CR for overall cognition and specific cognitive domains cross-sectionally and longitudinally in PD. METHODS: The cross-sectional analysis with data from the DEMPARK/LANDSCAPE study included 81 individuals without cognitive impairment (PD-N) and 87 individuals with mild cognitive impairment (PD-MCI). Longitudinal data covered 4 years with over 500 observations. CR was operationalized with the Lifetime of Experiences Questionnaire (LEQ), capturing the complexity of lifestyle activities across distinct life-stages. Cognition was assessed using a comprehensive neuropsychological test battery. RESULTS: ≤ 0.441) revealed that LEQ scores were positively related to cognitive performance independent of time. However, the decline in overall cognition and memory over time was slightly more pronounced with higher LEQ scores. CONCLUSIONS: This study emphasizes the association between complex lifestyle activities and cognition in PD. Data indicate that while CR might be related to a delay of cognitive decline, individuals with high CR may experience a more pronounced drop in overall cognition and memory. Future studies will have to replicate these findings, particularly regarding domain-specific effects and considering reverse causal mechanisms.