Birth Cohorts and Cognitive Reserve Influence Cognitive Performances in Older Adults

J Alzheimers Dis. 2022;85(2):587-604. doi: 10.3233/JAD-215044.


Background: Evidence suggests birth cohort differences in cognitive performance of older adults. Proxies of cognitive reserve (CR), such as educational attainment and occupational complexity, could also partly account for these differences as they are influenced by the sociocultural environment of the birth cohorts.

Objective: To predict cognitive performance using birth cohorts and CR and examine the moderating influence of CR on cognitive performance and structural brain health association.

Methods: Using ADNI data (n = 1628), four birth cohorts were defined (1915-1928; 1929-1938; 1939-1945; 1946-1964). CR proxies were education, occupational complexity, and verbal IQ. We predicted baseline cognitive performances (verbal episodic memory; language and semantic memory; attention capacities; executive functions) using multiple linear regressions with CR, birth cohorts, age, structural brain health (total brain volume; total white matter hyperintensities volume) and vascular risk factors burden as predictors. Sex and CR interactions were also explored.

Results: Recent birth cohorts, higher CR, and healthier brain structures predicted better performance in verbal episodic memory, language and semantic memory, and attention capacities, with large effect sizes. Better performance in executive functions was predicted by a higher CR and a larger total brain volume, with a small effect size. With equal score of CR, women outperformed men in verbal episodic memory and language and semantic memory in all cohorts. Higher level of CR predicted better performance in verbal episodic memory, only when total brain volume was lower.

Conclusion: Cohort differences in cognitive performance favor more recent birth cohorts and suggests that this association may be partly explained by proxies of CR.

Keywords: Aging; birth cohorts; cognition; cognitive impairments; cognitive reserve; generations.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Birth Cohort*
  • Brain / pathology
  • Canada
  • Cognitive Reserve*
  • Educational Status
  • Executive Function
  • Female
  • Humans
  • Language
  • Linear Models
  • Male
  • Memory, Episodic
  • Middle Aged
  • Neuropsychological Tests
  • Organ Size
  • United States