Concepts for brain aging: Resistance, resilience, reserve, and compensation

Thomas J. Montine, Brenna A. Cholerton, Maria M. Corrada, Steven D. Edland, Margaret E. Flanagan, Laura S. Hemmy, Claudia H. Kawas, Lon R. White

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations


A primary goal of research in cognitive impairment and dementia is to understand how some individuals retain sufficient cognitive function for a fulfilling life while many others are robbed of their independence, sometimes their essence, in the last years and decades of life. In this commentary, we propose operational definitions of the types of factors that may help individuals retain cognitive function with aging. We propose operational definitions of resistance, resilience, reserve, with an eye toward how these may be measured and interpreted, and how they may enable research aimed at prevention. With operational definitions and quantification of resistance, resilience, and reserve, a focused analytic search for their determinants and correlates can be undertaken. This approach, essentially a search to identify protective risk factors and their mechanisms, represents a relatively unexplored pathway toward the identification of candidate preventive interventions.

Original languageEnglish (US)
Article number22
JournalAlzheimer's Research and Therapy
Issue number1
StatePublished - Mar 11 2019

Bibliographical note

Funding Information:
We would like to acknowledge the following foundation and grants: The Chia-Ling Chang Fund of the Hawaii Community Foundation. NIA grant UF1AG053983, Cognitive Resilience to Alzheimer Neuropathologic Changes in the Honolulu-Asia Aging Study and the Nun Study. NIA grant UF1AG057707, Neuropathologic Substrates for Motor and Cognitive Impairment in Three Existing Cohort Studies of Alzheimer’s Disease and Related Dementias.

Publisher Copyright:
© 2019 The Author(s).


  • Alzheimer's disease
  • Reserve capacity
  • Resilience
  • Resistance


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