Researchers have unlocked new insights into why some brains stay sharp as we age, despite signs of damage, in a new paper examining ​‘cognitive resilience’ and dementia prevention.

Associate Professor Claire Shepherd from the Sydney Brain Bank at NeuRA collaborated with researchers from UNSW Sydney’s Centre for Healthy Brain Ageing (CHeBA), on the paper ​“Cognitive Resilience in Ageing” published in The Lancet Neurology.

“Cognitive resilience is the brain’s capacity to maintain cognition and function with ageing and disease,” Associate Professor Shepherd said.

“This review highlighted how advances in brain imaging and blood-based biomarkers are transforming dementia research and prevention. It also discussed how social determinants of health, such as education, socioeconomic conditions, diet and exercise can shape cognitive resilience across the lifespan.

“The review is important because it provides a snapshot of where the research is converging and what it says about what we can do to boost cognitive resilience and prevent dementia, but also acknowledges the work still required.”

Until recently, the true extent of brain pathology could only be confirmed after death. Advances in neuroimaging, electroencephalography, and cerebrospinal fluid and blood biomarkers now allow researchers to study Alzheimer’s disease and cerebrovascular disease in living people, and to track how these changes relate to cognitive function over time.

“The presence of brain pathology doesn’t always predict cognitive decline,” Associate Professor Shepherd said.

“Advances in imaging and biomarkers are helping us measure resilience in real time and follow this longitudinally, which will help us understand why some brains withstand damage better than others, and unlock new ways to slow or prevent cognitive decline.

“My research aligns with this, as we work with volunteers to track their health and wellbeing during life, and collect their brains after death to understand healthy ageing and cognitive decline.”

The research team also identified areas for future research, including developing reliable and uniform measures of cognitive resilience, integration of functional assessments and cognitive performance, imaging and biomarkers, plus further exploration of modifiable factors and multicomponent trials of strategies to promote cognitive resilience.

You can read the paper here.