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Article Abstract

Background: Previous cross-sectional work has suggested that higher cognitive reserve (CR) is associated with better cognitive performance and slower cognitive decline in Parkinson's disease (PD); however, these findings need confirmation in prospective longitudinal designs. The current study therefore examined how CR influences both cognitive function and the rate of cognitive deterioration in a longitudinal PD cohort.

Methods: This study utilized a prospective, longitudinal design and recruited participants from Tianjin Huanhu Hospital between September 2017-September 2019. PD patients were followed up for clinical assessment at an average of 2 ± 0.6 years.

Results: Higher CR levels were associated with better cognitive performance and reduced cognitive decline over a 2-year follow-up period. Linear regression analysis revealed significant positive associations between CR and the 2-year change rate of Montreal cognitive assessment (MoCA) scores, with age and apolipoprotein E (APOE) genotype being significant predictors. Logistic regression indicated that CR Index (CRI) components (education, working activity, and leisure time) and intelligence quotient (IQ) were independently associated with cognitive decline risk.

Conclusions: The study highlights the importance of CR in mitigating cognitive decline in PD and suggests that interventions to enhance CR could be beneficial for PD patients. Future research should focus on elucidating the underlying mechanisms and developing targeted interventions to support cognitive health in PD.

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http://dx.doi.org/10.1016/j.parkreldis.2025.108001DOI Listing

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