Skip to main content

Psychometric properties of the Italian version of the Cognitive Reserve Scale (I-CRS)

Neurological Sciences volume 39, pages 1383–1390 (2018)Cite this article

Abstract

The original definition of cognitive reserve (CR) refers to the individual differences in cognitive performance after a brain damage or pathology. Several proxies were proposed to evaluate CR (education, occupational attainment, premorbid IQ, leisure activities). Recently, some scales were developed to measure CR taking into account several cognitively stimulating activities. The aim of this study is to adapt the Cognitive Reserve Scale (I-CRS) for the Italian population and to explore its psychometric properties. I-CRS was administered to 547 healthy participants, ranging from 18 to 89 years old, along with neuropsychological and behavioral scales to evaluate cognitive functioning, depressive symptoms, and apathy. Cronbach’s α, corrected item-total correlations, and the inter-item correlation matrix were calculated to evaluate the psychometric properties of the scale. Linear regression analysis was performed to build a correction grid of the I-CRS according to demographic variables. Correlational analyses were performed to explore the relationships between I-CRS and neuropsychological and behavioral scales. We found that age, sex, and education influenced the I-CRS score. Young adults and adults obtained higher I-CRS scores than elderly adults; women and participants with high educational attainment scored higher on I-CRS than men and participants with low education. I-CRS score correlated poorly with cognitive and depression scale scores, but moderately with apathy scale scores. I-CRS showed good psychometric properties and seemed to be a useful tool to assess CR in every adult life stage. Moreover, our findings suggest that apathy rather than depressive symptoms may interfere with the building of CR across the lifespan.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Stern Y (2009) Cognitive reserve. Neuropsychologia 47:2015–2028. https://doi.org/10.1016/j.neuropsychologia.2009.03.004

    Article  PubMed  PubMed Central  Google Scholar 

  2. Stern Y (2002) What is cognitive reserve? Theory and research application of the reserve concept. J Int Neuropsychol Soc 8:448–460. https://doi.org/10.1017/S1355617702813248

    Article  PubMed  Google Scholar 

  3. Meng X, D’Arcy C (2012) Education and dementia in the context of the cognitive reserve hypothesis: a systematic review with meta-analyses and qualitative analyses. PLoS One 7:e38268. https://doi.org/10.1371/journal.pone.0038268

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Opdebeeck C, Martyr A, Clare L (2016) Cognitive reserve and cognitive function in healthy older people: a meta-analysis. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 23:40–60. https://doi.org/10.1080/13825585.2015.1041450

    Article  PubMed  Google Scholar 

  5. Stern Y, Albert S, Tang MX, Tsai WY (1999) Rate of memory decline in AD is related to education and occupation: cognitive reserve? Neurology 53:1942–1947. https://doi.org/10.1212/WNL.53.9.1942

    Article  PubMed  CAS  Google Scholar 

  6. Garibotto V, Borroni B, Kalbe E, Herholz K, Salmon E, Holtoff V, Sorbi S, Cappa SF, Padovani A, Fazio F, Perani D (2008) Education and occupation as proxies for reserve in aMCI converters and AD: FDG-PET evidence. Neurology 71:1342–1349. https://doi.org/10.1212/01.wnl.0000327670.62378.c0

    Article  PubMed  CAS  Google Scholar 

  7. Ghaffar O, Fiati M, Feinstein A (2012) Occupational attainment as a marker of cognitive reserve in multiple sclerosis. PLoS One 7:e47206. https://doi.org/10.1371/journal.pone.0047206

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Scarmeas N, Zarahn E, Anderson KE, Habeck CG, Hilton J, Flynn J, Marder KS, Bell KL, Sackeim HA, Van Heertum RL, Moeller JR, Stern Y (2003) Association of life activities with cerebral blood flow in Alzheimer disease: implications for the cognitive reserve hypothesis. Arch Neurol 60:359–365. https://doi.org/10.1001/archneur.60.3.359

    Article  PubMed  PubMed Central  Google Scholar 

  9. Feinstein A, Lapshin H, O’Connor P, Lanctôt KL (2013) Sub-threshold cognitive impairment in multiple sclerosis: the association with cognitive reserve. J Neurol 260:2256–2261. https://doi.org/10.1007/s00415-013-6952-9

    Article  PubMed  Google Scholar 

  10. Steward KA, Kennedy R, Novack TA, Crowe M, Marson DC, Triebel KL (2017) The role of cognitive reserve in recovery from traumatic brain injury. J Head Trauma Rehabil. https://doi.org/10.1097/HTR.0000000000000325

  11. Caffò AO, Lopez A, Spano G, Saracino G, Stasolla F, Ciriello G, Grattagliano I, Lancioni GE, Bosco A (2016) The role of pre-morbid intelligence and cognitive reserve in predicting cognitive efficiency in a sample of Italian elderly. Aging Clin Exp Res 28:1203–1210. https://doi.org/10.1007/s40520-016-0580-z

    Article  PubMed  Google Scholar 

  12. Sumowski JF, Rocca MA, Leavitt VM, Riccitelli G, Comi G, DeLuca J, Filippi M (2013) Brain reserve and cognitive reserve in multiple sclerosis: what you’ve got and how you use it. Neurology 80:2186–2193, Erratum in: Neurology 81:604. https://doi.org/10.1212/WNL.0b013e318296e98b

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Scarmeas N, Levy G, Tang MX, Manly J, Stern Y (2001) Influence of leisure activity on the incidence of Alzheimer’s disease. Neurology 57:2236–2242. https://doi.org/10.1212/WNL.57.12.2236

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  14. Fazeli PL, Woods SP, Heaton RK, Umlauf A, Gouaux B, Rosario D, Moore RC, Grant I, Moore DJ, HNRP Group (2014) An active lifestyle is associated with better neurocognitive functioning in adults living with HIV infection. J Neuro-Oncol 20:233–242. https://doi.org/10.1007/s13365-014-0240-z

    Article  Google Scholar 

  15. Wilson RS, Mendes De Leon CF, Barnes LL, Schneider JA, Bienias JL, Evans DA, Bennett DA (2002) Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA 287:742–748. https://doi.org/10.1001/jama.287.6.742

    Article  PubMed  Google Scholar 

  16. Sumowski JF, Wylie GR, Gonnella A, Chiaravalloti N, DeLuca J (2010) Premorbid cognitive leisure independently contributes to cognitive reserve in multiple sclerosis. Neurology 75:1428–1431. https://doi.org/10.1212/WNL.0b013e3181f881a6

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  17. Valenzuela MJ, Sachdev P (2007) Assessment of complex mental activity across the lifespan: development of the Lifetime of Experiences Questionnaire (LEQ). Psychol Med 37:1015–1025. https://doi.org/10.1017/S003329170600938X

    Article  PubMed  Google Scholar 

  18. Rami L, Valls-Pedret C, Bartrés-Faz D, Caprile C, Solé-Padullés C, Castellvi M, Olives J, Bosch B, Molinuevo JL (2011) Cognitive reserve questionnaire. Scores obtained in a healthy elderly population and in one with Alzheimer’s disease. Rev Neurol 52:195–201

    PubMed  Google Scholar 

  19. Nucci M, Mapelli D, Mondini S (2012) Cognitive reserve index questionnaire (CRIq): a new instrument for measuring cognitive reserve. Aging Clin Exp Res 24:218–226. https://doi.org/10.3275/7800

    PubMed  Article  Google Scholar 

  20. León I, García-García J, Roldán-Tapia L (2014) Estimating cognitive reserve in healthy adults using the Cognitive Reserve Scale. PLoS One 9:e102632. https://doi.org/10.1371/journal.pone.0102632

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  21. Beaton DE, Bombardier C, Guillemin F, Bosi Ferraz M (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 25:3186–3191

    Article  PubMed  CAS  Google Scholar 

  22. Measso G, Cavarzeran F, Zappalà G, Lebowitz BD, Crook TH, Pirozzolo FJ, Amaducci LA, Massari D, Grigoletto F (1993) The mini-mental state examination: normative study of an Italian random sample. Dev Neuropsychol 9:77–95. https://doi.org/10.1080/87565649109540545

    Article  Google Scholar 

  23. World Medical Association (2013) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 310:2191–2194. https://doi.org/10.1001/jama.2013.281053

    Article  CAS  Google Scholar 

  24. Santangelo G, Siciliano M, Pedone R, Vitale C, Falco F, Bisogno R, Siano P, Barone P, Grossi D, Santangelo F, Trojano L (2015) Normative data for the Montreal Cognitive Assessment in an Italian population sample. Neurol Sci 36:585–591. https://doi.org/10.1007/s10072-014-1995-y

    Article  PubMed  Google Scholar 

  25. Carlesimo GA, Caltagirone C, Gainotti G (1996) The mental deterioration battery: normative data, diagnostic reliability and qualitative analyses of cognitive impairment. The group for the standardization of the mental deterioration battery. Eur Neurol 36:378–384. https://doi.org/10.1159/000117297

    Article  PubMed  CAS  Google Scholar 

  26. Spinnler H, Tognoni G (1987) Standardizzazione e taratura di test neuropsicologici. Neurol Sci 8:1–120

    Google Scholar 

  27. Beck AT, Steer RA, Brown GK (2006) BDI-II. Beck Depression Inventory-II. Giunti OS, Firenze

    Google Scholar 

  28. Radakovic R, Abrahams S (2014) Developing a new apathy measurement scale: dimensional apathy scale. Psychiatry Res 219:658–663. https://doi.org/10.1016/j.psychres.2014.06.010

    Article  PubMed  Google Scholar 

  29. Santangelo G, Raimo S, Siciliano M, D'Iorio A, Piscopo F, Cuoco S, Bottone M, Trojsi F, Grossi D, Trojano L (2017) Assessment of apathy independent of physical disability: validation of the Dimensional Apathy Scale in Italian healthy sample. Neurol Sci 38:303–309. https://doi.org/10.1007/s10072-016-2766-8

    Article  PubMed  Google Scholar 

  30. Cronbach LJ (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16:297–334. https://doi.org/10.1007/s13365-014-0240-z

    Article  Google Scholar 

  31. Satz P (1993) Brain reserve capacity on symptom onset after brain injury: a formulation and review of evidence for threshold theory. Neuropsychology 7:273–295

    Article  Google Scholar 

  32. Kim HY (2015) Statistical notes for clinical researchers: post-hoc multiple comparisons. Restor Dent Endod 40:172–176. https://doi.org/10.5395/rde.2015.40.2.172

    Article  PubMed  PubMed Central  Google Scholar 

  33. León I, García-García J, Roldán-Tapia L (2015) Cognitive reserve scale and ageing. Anales De Psicología/Ann Psychol 32:218–223. https://doi.org/10.6018/analesps.32.1.182331

    Article  Google Scholar 

  34. Grotz C, Seron X, Van Wissen M, Adam S (2017) How should proxies of cognitive reserve be evaluated in a population of healthy older adults? Int Psychogeriatr 29:123–136. https://doi.org/10.1017/S1041610216001745

    Article  PubMed  Google Scholar 

  35. Sumowski JF, Wylie GR, DeLuca J, Chiaravalloti N (2010) Intellectual enrichment is linked to cerebral efficiency in multiple sclerosis: functional magnetic resonance imaging evidence for cognitive reserve. Brain 133(2):362–374. https://doi.org/10.1093/brain/awp307

    Article  PubMed  Google Scholar 

  36. Sumowski JF, Chiaravalloti N, DeLuca J (2009) Cognitive reserve protects against cognitive dysfunction in multiple sclerosis. J Clin Exp Neuropsychol 31:913–926. https://doi.org/10.1080/13803390902740643

    Article  PubMed  Google Scholar 

  37. Roldán-Tapia MD, Cánovas R, León I, García-Garcia J (2017) Cognitive vulnerability in aging may be modulated by education and reserve in healthy people. Front Aging Neurosci 9:340

    Article  PubMed  PubMed Central  Google Scholar 

  38. Palmer K, Di Iulio F, Varsi AE, Gianni W, Sancesario G, Caltagirone C, Spalletta G (2010) Neuropsychiatric predictors of progression from amnestic-mild cognitive impairment to Alzheimer’s disease: the role of depression and apathy. J Alzheimers Dis 20:175–183. https://doi.org/10.3233/JAD-2010-1352

    Article  PubMed  Google Scholar 

  39. Richard E, Schmand B, Eikelenboom P, Yang SC, Ligthart SA, Moll van Charante EP, van Gool WA, Alzheimer’s Disease Neuroimaging Initiative (2012) Symptoms of apathy are associated with progression from mild cognitive impairment to Alzheimer’s disease in non-depressed subjects. Dement Geriatr Cogn Disord 33:204–209. https://doi.org/10.1159/000338239

    Article  PubMed  CAS  Google Scholar 

  40. Sumowski JF (2015) Cognitive reserve as a useful concept for early intervention research in multiple sclerosis. Front Neurol 6:176. https://doi.org/10.3389/fneur.2015.00176

    Article  PubMed  PubMed Central  Google Scholar 

  41. Koerts J, Tucha L, Lange KW, Tucha O (2013) The influence of cognitive reserve on cognition in Parkinson’s disease. J Neural Transm 120:593–596. https://doi.org/10.1007/s00702-012-0916-6

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Giuseppe Basile, Alfonsina d’Iorio, Fausta Piscopo, and Claudio Troili for support in the scoring of the questionnaires.

Author information

Affiliations

  1. Department of Psychology, University of Campania “Luigi Vanvitelli”, 81100, Caserta, Italy

    Manuela Altieri, Mattia Siciliano, Simona Pappacena, Luigi Trojano & Gabriella Santangelo

  2. Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Mattia Siciliano

  3. Department of Psychology, Research Centre of Neuropsychological Evaluation and Rehabilitation, University of Almería, Almería, Spain

    María Dolores Roldán-Tapia

  4. ICS Maugeri, Institute of Telese, IRCCS, 82037, Telese Terme, BN, Italy

    Luigi Trojano

Authors
  1. Manuela Altieri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mattia Siciliano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simona Pappacena
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. María Dolores Roldán-Tapia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luigi Trojano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gabriella Santangelo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gabriella Santangelo.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Altieri, M., Siciliano, M., Pappacena, S. et al. Psychometric properties of the Italian version of the Cognitive Reserve Scale (I-CRS). Neurol Sci 39, 1383–1390 (2018). https://doi.org/10.1007/s10072-018-3432-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-018-3432-0

Keywords

  • Cognitive reserve
  • Cognitive reserve scale
  • Assessment
  • Adaptation
  • Cognitive impairment