Influence of cognitive reserve on neuropsychological functioning in Parkinson's disease.

Background: In recent years, attention has been drawn to the association between a low level of education and dementia, an almost generalized finding in the majority of studies on the prevalence of dementia where the level of education of the population was highly diversified. The protective effect of education is not limited to Alzheimer's disease but is also seen in other types of dementia, Parkinson's disease (PD), and even in the cognitive deterioration linked to aging Objective: To evaluate neuropsychological performance in (PD) subjects and to evaluate the influence of cognitive reserve (RC) on their neuropsychological performance. Subjects: An extensive neuropsychological battery of tests was applied to a total of 79 subjects, 33 of whom were diagnosed with PD. Measures: RC scores were based on a combination of years of education, a measure of occupational attainment, and an estimate of premorbid intelligence. Results: As regards the specific disturbances found in the clinical group subjects, a lower performance in memory, attention, visuospatial, visuoconstructive, and perceptive skills was seen. With respect to our second objective, our results showed that patients diagnosed with PD who had a high RC reached a higher neuropsychological level of performance than those subjects with a low reserve. Conclusions: Early neuropsychological impairments in PD are most evident in individuals with lower RC. As has been found in other neurological disorders, individuals with greater RC may be less sensitive to the initial clinical effects of the underlying neuropathological process.