Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 6, 2016
   Pages 863 — 872

Abstract — Cognitive reserve and executive function: Effect on judgment of health and safety

Kristin H. Hinrichs, MS;1* Alex Hayek;1 David Kalmbach, MA;1 Nicolette Gabel, PhD;2 Linas A. Bieliauskas, PhD1,3

Departments of 1Psychiatry and 2Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI; 3Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI

Abstract — Individuals with the same neurological conditions do not necessarily manifest the same behavioral presentation, which suggests differences in resilience and vulnerability among individuals, a concept known as cognitive reserve. This study sought to explore the relationship among cognitive reserve, executive functioning, and health and safety judgment in a sample of older adult inpatients in an extended medical care unit at a Veterans Health Administration hospital. We hypothesized that cognitive reserve, as determined by an estimate of premorbid intellectual ability, would act as a protective factor against poor judgment in older adults with executive dysfunction. Participants included 200 Veterans who completed a comprehensive neuropsychological assessment, including measures of health and safety judgment, executive functioning, global cognitive functioning, and premorbid intellectual ability. After controlling for global cognitive functioning, executive functioning abilities did not have an effect on judgment abilities among those with high estimated intellectual ability. However, executive functioning had a significant effect on judgment abilities among those with low estimated intellectual ability. Our results suggest that intact executive functioning is critical for making appropriate health and safety decisions for patients with lower measured intellectual abilities and provide further support for the cognitive reserve model. Clinical implications are also discussed.

Key words: aging, assessment, cognitive decline, cognitive reserve, executive functioning, health, intellectual ability, judgment, neuropsychology, treatment planning.


View HTML ¦ View PDF ¦ Contents Vol. 53, No. 6
This article and any supplementary material should be cited as follows:
Hinrichs KH, Hayek A, Kalmbach D, Gabel N, Bieliauskas LA. Cognitive reserve and executive function: Effect on judgment of health and safety. J Rehabil Res Dev. 2016;53(6):863–72.
http://dx.doi.org/10.1682/JRRD.2015.04.0073
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