Cognitive Reserve and Mild Cognitive Impairment in Older Adults of Low Socioeconomic Status: Evidence from an Observational Study in Colombia.

Abstract

Objectives: The construct of cognitive reserve (CR) suggests that environmental factors influence cognition over time, resulting in a more resilient response to pathology or adverse conditions in some individuals. The goal of this study was to identify and analyze differences in CR among older adults of low socioeconomic status (SES).

Methods: A sample of 102 older adults, both with (n = 52) and without (n = 50) amnestic mild cognitive impairment (aMCI), underwent a cognitive assessment protocol including the Cognitive Reserve Index Questionnaire (CRIq). Participants' SES levels were classified using the European Society for Opinion and Marketing Research Standard Demographic Classification. Mean and distributional comparisons, logistic regression, and receiver operating characteristic (ROC) analysis were conducted.

Results: Mean comparisons and distribution analysis showed that participants with aMCI had lower CR than those without aMCI. Logistic regression models revealed that CRIq score predicted aMCI in this population (OR = 0.955, p < 0.001), particularly through education (OR = 0.546, p < 0.001) and work (OR = 0.970, p < 0.001) dimensions. ROC curve results indicate the model has adequate discriminatory power, with an area under the curve (AUC) of 0.738.

Discussion: Low CR is a sign of pathological cognition in low SES older adults. A higher level of CR in subjects with low SES, even if not meeting the criteria for High CR, has a role in mitigating aMCI. Future studies expand on these findings by examining the relationship between CR and SES in the brain-behavior association, including biomarkers such as the A/T/N framework.