Brain Reserve and Cognitive Reserve – What They Are and Why They Matter

We’ve all heard the terms “brain reserve” and “cognitive reserve,” but understanding what they are, and why they matter – particularly for anyone who lives with MS and/or is aging – can be challenging. In this article, we’ll define these important concepts, explain the relationship between them, and offer strategies for optimizing them.  

• Reserve – like a savings account – refers to what we have on hand as back-up to meet our needs.  

• Brain Reserve, which refers to the brain’s physical size and structure, amount of neural tissue and numbers of synaptic connections, is initially determined by genetics, prenatal nutrition, and exposure to various aspects of the environment in a person’s first months of life. In other words, a person’s baseline brain reserve is established very early on. However, each person’s brain – to a greater or lesser degree – has the ability to adapt and build new connections over the course of that person’s life. This type of adaptability is referred to as “brain plasticity.” The brain’s reserve helps it to withstand damage or disease as long as possible before symptoms emerge. Fortunately, a person’s brain reserve can be enhanced with a range of lifestyle activities.  

• Cognitive Reserve refers to the brain’s ability to adapt, problem solve, think creatively, and/or adapt to damage (such as that caused by MS and other neurological disorders). In MS or aging, cognitive reserve kicks in as neurologic changes begin to impact thinking, memory, and other aspects of cognitive functioning. It allows a person’s cognitive processes to continue as efficiently as possible in spite of the damage that has occurred.  Given the same amount of brain reserve, some people are better able than others to manage brain changes related to aging or disease. Like brain reserve, cognitive reserve can also be cultivated through lifestyle behaviors. 

How Brain and Cognitive Reserve are Measured

Brain reserve can be measured with a range of anatomical measures including head circumference, brain volume, and number of synapses, among other anatomical features. However, certain factors related to lifetime experience are typically used as proxies for these measurements. These factors include socioeconomic variables like income and occupational achievement, education level, and amount and types of leisure activity. Studies have shown that educational and occupational attainment, as well as recreational activities, contribute independently to a person’s reserves over time – which brings us to the strategies we can all use to increase our reserves and enhance our cognitive functioning.  

Strategies for Building and Maintaining Our Reserves

The miracle of brain plasticity is that our brains can evolve over our lifetime – finding new connections when existing ones are damaged or blocked. We can nurture this evolution in a variety of ways: 

• Exercising Your Brain  

• Learning new skills (a foreign language, a new craft or hobby, playing a new game) 

• Engaging in harder and more complex activities (a competitive game, using the computer, reading fiction and non-fiction, pushing limits reaching for higher goals) 

•  Looking for new experiences to try (traveling to new places, trying new recipes, seeking activities that challenge your brain power) 

• Trading screen time for more stimulating activities 

• Attending to Your Physical Health 

• Getting the Recommended Amount of Exercise/Physical Activity (150 minutes per week of structured exercise and/or lifestyle physical activities, such as walking, cleaning the house, mowing the lawn, making a bed).  

• Eating a balanced, heart-healthy diet (lean proteins, whole grains, colorful fruits and vegetables, beans, and nuts) 

• Getting Restful Sleep 

• 7-9 hours of sleep to allow your brain to rest (establishing a regular schedule, managing the symptoms that disrupt your sleep or your partner’s, turning off screens well before going to sleep) 

• Attending to Your Emotional and Social Well-Being 

• Staying active and engaged with others (socializing, entertaining, book groups, knitting circles) 

• Engaging in stress reduction activities (meditation, deep breathing, journaling, engaging in a favorite hobby) 

• Paying attention to your mood (depression and anxiety are common in both people with MS and their care partners) 

Start Somewhere

So, start somewhere! Pick an area of your life you’d like to focus on and reach out to your healthcare team and Can Do MS for support and suggestions. Regardless of your innate abilities, education level, work experience, or health history, you can foster your brain’s plasticity and increase your cognitive reserve. And the greater your reserve, the better able you will be to delay the effects of neurologic damage and/or aging.