Profiling Cognitive Reserve Among Community-Dwelling Older Adults: A Latent Class Analysis

TL;DR

This study identifies two distinct cognitive reserve profiles in older adults, showing that higher reserve is linked to better cognitive and physical health outcomes.

Contribution

The study introduces a novel approach using latent class analysis to uncover distinct cognitive reserve profiles and their clinical correlates in older adults.

Findings

Class 2 participants had higher cognitive scores and fewer cognitive decline symptoms compared to Class 1.

Class 2 was associated with lower frailty burden and better chewing ability.

Higher income and male gender were more common in Class 2, while age was inversely associated with Class 2 membership.

Abstract

Cognitive reserve (CR) is a multidimensional construct shaped by education, occupation, and leisure activities, yet traditional scoring approaches obscure heterogeneity among older adults. This study applied latent class analysis (LCA) to identify distinct CR profiles and examine their clinical correlates. A cross-sectional sample of 426 community-dwelling older adults aged ≥65 years in Beijing, China, was assessed using the Cognitive Reserve Index questionnaire (CRIq). Two CR profiles emerged: Class 1, characterized by low reading and leisure engagement (51.9%), and Class 2, defined by higher educational attainment and cognitively demanding occupations (48.1%). Compared with Class 1, Class 2 participants had higher Montreal Cognitive Assessment scores (26 vs. 25, p < 0.001), fewer subjective cognitive decline symptoms (3.5 vs. 4.5, p < 0.001), and lower frailty burden (Fried phenotype score: 0 vs. 1, p = 0.006). Class 2 membership was also associated with better chewing ability (p = 0.004), higher household income (p < 0.001), and greater likelihood of being male (p = 0.007). Age was inversely associated with Class 2 membership (β=–0.060, p = 0.024). These findings reveal meaningful heterogeneity in CR within aging populations and highlight the importance of stratifying older adults by CR profiles. Identifying subgroups at risk for cognitive decline and frailty provides new opportunities for targeted interventions to promote resilience for aging.