If cognitive systems can build reserve, why should affective systems not do the same? Despite decades of research on brain reserve and cognitive reserve, substantial interindividual variability in affective and cognitive trajectories across the lifespan remains unexplained. Building on the original conceptualization of affective reserve (AR), the present paper further develops AR as a distinct reserve mechanism that extends reserve theory beyond cognition to affective functioning. AR is proposed as a higher-order capacity built and strengthened across the lifespan through the engagement in meaningful and adaptive life experiences that promote the development and the employment of adaptive coping and emotion regulation strategies, and that may involve supportive social relationships. AR is proposed as a higher-order capacity built and strengthened across the lifespan through engagement in meaningful and adaptive life experiences that promote the development and employment of adaptive coping and emotion regulation strategies, and that may involve supportive social relationships. Therefore, AR is hypothesized to constitute an integrated and cumulative affective resource that contributes to resilience and helps explain individual differences in mental health trajectories, beyond what can be explained by cognitive reserve. Given the interdependence of affective and cognitive systems, AR may indeed contribute to both affective and cognitive trajectories and potentially influence the clinical expression of age-related neuropathology and dementia. The present framework specifies the developmental basis and conceptual boundaries of AR, distinguishing it from related constructs including cognitive reserve, emotional reserve, motivational reserve, emotional intelligence, and resilience, and derives testable predictions for future empirical research. By extending reserve theory from cognition to affective functioning, this framework provides a basis for investigating whether cumulative affective system adaptability might represent a previously underexplored source of interindividual variability in mental health, aging, and brain health.
Background: Neuropsychiatric symptoms of dementia (NPS) are common and have significant negative impacts. Behavioral interventions are the first line for the management of NPS. The Baycrest Quick-Response Caregiver Tool (BQRCT) is a novel intervention that assists caregivers in managing NPS in real time. The current study examined the utility and feasibility of the tool for health care professionals in long-term care (LTC). Methods: Participants completed an online training module, and immediate pre/post and follow-up surveys after 4 weeks. Survey data included face-valid Likert questions for program impact, feasibility questions, and the Pearlin Caregiver Competence Scale. Results: Ninety-six participants completed the immediate pre post survey, and 52 completed the follow-up survey at 4 weeks posttraining. The BQRCT-LTC was found to be useful, easy to understand, and implement. The overwhelming majority of participants would recommend the tool to other LTC staff. At the 4-week follow-up, there was a significant improvement on the Pearlin Caregiver Competence Scale, increasing from a mean score of 13.92 (SD=2.21) at pre to a mean score of 14.56 (SD=1.73) at the 4-week follow-up, with a mean difference of 0.64 (SD=2.22, P =0.044). Conclusion: The BQRTC-LTC was found to be feasible and useful in the LTC setting. After 4 weeks, the tool increased caregiver competence in a group of experienced staff in LTC. Future studies may consider measuring the tools impact on the frequency and severity of NPS.
Background: Arterial stiffness may contribute to Alzheimer disease (AD) pathogenesis. Estimated pulse wave velocity (ePWV) is a noninvasive marker of arterial stiffness, yet its longitudinal association with AD remains unclear. Methods: This prospective cohort study included 14,602 participants aged 45 years or older without baseline AD from HRS (2010 to 2020) and ELSA (2004 to 2018). ePWV was calculated using the Greve formula. Cox models estimated HRs for AD per 1 m/s increase in ePWV, with sequential adjustments. Restricted cubic splines examined dose-response relationships. Results: Over median follow-ups of 8.2 years (HRS) and 10.2 years (ELSA), 203 and 136 incident AD cases occurred. In fully adjusted models, each 1 m/s increment in ePWV was associated with 39% (HR=1.39) and 63% (HR=1.63) increased AD risk, respectively. Positive dose-response associations were observed without clear threshold effects. Subgroup analyses showed consistent results across most strata. Conclusions: Elevated ePWV is independently associated with increased AD risk, suggesting its potential as a risk stratification tool for AD prevention.
Current dementia research and clinical practice primarily rely on cognitive and functional outcomes, which may not fully capture what matters most in the lives of people with dementia. Drawing on the capability approach, this paper proposes a shift in focus from deficits to what individuals are able to be and do. We argue that outcomes in dementia research can be understood hierarchically, from impairment and function to well-being and ultimately to capability. Using the example of the “blank period” following diagnosis in Japan, we illustrate how limited support may lead to a decline in quality of life, despite early diagnosis. In contrast, community-based and relational interventions may help sustain meaningful lives even in the presence of cognitive impairment. We further suggest that capability should be understood as dynamic and relational, emerging through interactions with others. This perspective offers an expanded ethical and practical framework for dementia care.
Background: Understanding how early-life reproductive timing and educational context shape cognitive aging is critical for addressing disparities in dementia risk among women. However, few studies have examined the relationship between menarcheal age and cognition in a diverse sample. This study examined associations among menarchal timing, education, and episodic memory performance in an ethnically and racially diverse sample of older women from the Health and Aging Brain Study-Health Disparities. Methods: Using linear regression models, we assessed whether age at menarche and education were associated with performance on 2 commonly used episodic memory measures. Ethnicity-stratified sensitivity analyses and exploratory longitudinal mixed-effects models were also conducted. The sample included 780 women aged 50 years and older, racialized as non-Hispanic White, Hispanic, and Black. Results: Earlier age at menarche and higher educational attainment were independently associated with better episodic memory performance, with more robust and consistent associations observed for Logical Memory II compared with the Spanish-English Verbal Learning Test. Conclusion: These findings suggest that early-life reproductive timing and educational attainment are meaningfully related to episodic memory performance, with test-specific and context-sensitive patterns. Incorporating age at menarche and educational context into life-course approaches to brain health may improve the measurement of heterogeneity in cognitive aging.
