Cognitive reserve is associated with quality of life: A population-based study.
To assess the association between cognitive reserve (CR) and quality of life (QoL), as well as the role of depression, cognitive functioning, and disability in this association.



Nationally-representative cross-sectional population-based data on 1973 individuals aged ≥50years from the Spanish sample of the Collaborative Research on Ageing in Europe (COURAGE) study were analysed. CR was a composite score ranging from 0 to 25 obtained from the Cognitive Reserve Questionnaire, which is composed of items on training courses, occupation, musical training, languages, reading activities, intellectual games, and level of education of the participants and their parents. QoL, ranging from 0 to 100, was assessed with the WHOQOL-AGE. Multiple linear regression and mediation analyses were performed.



Higher levels of CR were associated with higher QoL, after controlling for potential confounders (Coef. 0.53; 95% CI=0.36, 0.70). The strongest mediator in this association was disability, which explained about half of the association, while depression and cognition explained 6-10% of this association.



CR is associated with higher QoL in older adults. Interventions targeting determinants of CR that can be modified or trained across the lifespan may lead to successful ageing by prolonging autonomous functioning and enhancing QoL.
Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Facultat de Medicina, Universitat de Barcelona, Casanova 143, 08036 Barcelona, Spain. Electronic address: e.lara@pssjd.org.
Elvira
E
Lara
Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
Ai
A
Koyanagi
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Diego de León, 62, 28006 Madrid, Spain.
Félix
F
Caballero
Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Facultat de Economía y Empresa, Universitat de Barcelona, Av. Diagonal 690, 08034 Barcelona, Spain.
Joan
J
Domènech-Abella
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Diego de León, 62, 28006 Madrid, Spain.
Marta
M
Miret
Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
Beatriz
B
Olaya
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Diego de León, 62, 28006 Madrid, Spain.
Laura
L
Rico-Uribe
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Diego de León, 62, 28006 Madrid, Spain.
Jose Luis
JL
Ayuso-Mateos
Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Facultat de Medicina, Universitat de Barcelona, Casanova 143, 08036 Barcelona, Spain.
Josep Maria
JM
Haro
D000368:Aged; D000375:Aging / Q000523:psychology*; D058245:Cognitive Reserve; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D015444:Exercise; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires
Cognition; Epidemiology; Spain; Well-being