A growing body of research suggests that regularly engaging in stimulating activities across multiple domains—physical, cultural, intellectual, communal, and spiritual—builds resilience. This project investigated the psychometric characteristics of the DeltaQuest Reserve-Building Measure for use in prospective research.
The study included Rare Patient Voice panel participants. The web-based survey included the Reserve-Building Measure with one-week re-test, measures of quality of life (QOL) and well-being (PROMIS General Health; NeuroQOL Cognitive Function and Positive Affect & Well-Being short-forms; Ryff Environmental Mastery subscale); and the Big Five Inventory-10 personality measure. Classical test theory and item response theory (IRT) analyses investigated psychometric characteristics of the Reserve-Building Measure.
This North American sample (n = 592) included both patients and caregivers [mean age = 44, SD 19)]. Psychometric analyses revealed distinct subscales measuring current reserve-building activities (Active in the World, Games, Outdoors, Creative, Religious/Spiritual, Exercise, Inner Life, Shopping/Cooking, Passive Media Consumption,), past reserve-building activities (Childhood Activities, Achievement), and reserve-related person-factors (Perseverance, Current and Past Social Support, and Work Value). Test–retest stability (n = 101) was moderately high for 11 of 15 subscales (ICC range 0.78–0.99); four were below 0.59 indicating a need for further refinement. IRT analyses supported the item functioning of all subscales. Correlational analyses suggest the measure’s subscales tap distinct constructs (range r = 0.11–0.46) which are not redundant with QOL, well-being, or personality (range r = 0.11–0.48).
The Reserve-Building Measure provides a measure of activities and person-factors related to reserve that may potentially be useful in prospective research.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Bonanno, G. A., & Diminich, E. D. (2013). Annual research review: Positive adjustment to adversity–trajectories of minimal–impact resilience and emergent resilience. Journal of Child Psychology and Psychiatry, 54(4), 378–401.
Bonanno, G. A., Kennedy, P., Galatzer-Levy, I. R., Lude, P., & Elfström, M. L. (2012). Trajectories of resilience, depression, and anxiety following spinal cord injury. Rehabilitation Psychology, 57(3), 236.
Stern, Y. (2007). Cognitive reserve: Theory and applications (p. 344). New York: Taylor & Francis.
Schwartz, C. E., Rapkin, B. D., & Healy, B. C. (2016). Reserve and reserve-building activities research: Key challenges and future directions. BMC Neuroscience, 17, 62.
Schwartz, C. E., Snook, E. M., Quaranto, B. R., Benedict, R. H., & Vollmer, T. (2013). Cognitive reserve and patient-reported outcomes. Multiple Sclerosis Journal, 19(1), 87–105.
Sumowski, J. F., Wylie, G. R., Chiaravalloti, N., & DeLuca, J. (2010). Intellectual enrichment lessens the effect of brain atrophy on learning and memory in multiple sclerosis. Neurology, 74(24), 1942–1945.
Stern, Y., Gurland, B., Tatemichi, T. K., Tang, M. X., Wilder, D., & Mayeux, R. (1994). Influence of education and occupation on the incidence of Alzheimer’s disease. Journal of the American Medical Association, 271(13), 1004–1010.
Benedict, R. H., Morrow, S. A., Weinstock Guttman, B., Cookfair, D., & Schretlen, D. J. (2010). Cognitive reserve moderates decline in information processing speed in multiple sclerosis patients. Journal of the International Neuropsychological Society, 16(5), 829–835.
Sumowski, J. F., Rocca, M. A., Leavitt, V. M., Dackovic, J., Mesaros, S., Drulovic, J., et al. (2014). Brain reserve and cognitive reserve protect against cognitive decline over 4.5 years in MS. Neurology, 82(20), 1776–1783.
Sumowski, J. F., Wylie, G. R., Gonnella, A., Chiaravalloti, N., & Deluca, J. (2010). Premorbid cognitive leisure independently contributes to cognitive reserve in multiple sclerosis. Neurology, 75(16), 1428–1431.
Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8, 448–460.
Sumowski, J. F., Rocca, M. A., Leavitt, V. M., Riccitelli, G., Comi, G., Deluca, J., et al. (2013). Brain reserve and cognitive reserve in multiple sclerosis: What you’ve got and how you use it. Neurology, 80(24), 2186–2193.
Stern, Y., Habeck, C., Moeller, J., Scarmeas, N., Anderson, K. E., Hilton, H. J., et al. (2005). Brain networks associated with cognitive reserve in healthy young and old adults. Cerebral Cortex, 15(4), 394–402.
Stern, Y. (2006). Cognitive reserve and Alzheimer disease. Alzheimer Disease and Associated Disorders, 20(2), 112–117.
Sumowski, J. F., & Leavitt, V. M. (2013). Cognitive reserve in multiple sclerosis. Mult Scler., 19(9), 1122–1127.
Goleman, D. (2006). Emotional intelligence: Bantam.
Sole-Padulles, C., Bartres-Faz, D., Junque, C., Vendrell, P., Rami, L., Clemente, I. C., et al. (2009). Brain structure and function related to cognitive reserve variables in normal aging, mild cognitive impairment and Alzheimer’s disease. Neurobiology of Aging, 30(7), 1114–1124.
Godin, G., & Shephard, R. (1997). Godin leisure-time exercise questionnaire. Medicine and Science in Sports and Exercise, 29(6), 36–38.
Development NCfON. O*NET Online. https://www.onetonline.org/.
Schwartz, C. E., Quaranto, B. R., Healy, B. C., Benedict, R. H., & Vollmer, T. L. (2013). Cognitive reserve and symptom experience in multiple sclerosis: A buffer to disability progression over time? Archives of Physical Medicine and Rehabilitation, 94(10), 1971–1981.
Schwartz, C. E., Snook, E., Quaranto, B., Benedict, R. H., Rapkin, B. D., & Vollmer, T. (2013). Cognitive reserve and appraisal in multiple sclerosis. Multiple Sclerosis and Related Disorders, 2(1), 36–44.
Schwartz, C. E., Ayandeh, A., Rodgers, J., Duberstein, P., Weinstock-Guttman, B., & Benedict, R. H. (2015). A new perspective on proxy report: Investigating implicit processes of understanding through patient-proxy congruence. Quality of Life Research, 24(11), 2637–2649.
Roy, S., Schwartz, C. E., Duberstein, P., Dwyer, M. G., Zivadinov, R., Bergsland, N., et al. (2016). Synergistic effects of reserve and adaptive personality in multiple sclerosis. Journal of the International Neuropsychological Society., 22, 1–8.
Schwartz, C. E., Quaranto, B. R., Healy, B. C., Benedict, R. H., & Vollmer, T. L. (2013). Altruism and health outcomes in multiple sclerosis: The effect of cognitive reserve. The Journal of Positive Psychology, 8(2), 144–152.
Sherbourne, C. D., & Stewart, A. L. (1991). The MOS social support survey. Social Science and Medicine, 32(6), 705–714.
Lubben, J. E. (1988). Assessing social networks among elderly populations. Family & Community Health, 11(3), 42–52.
Schwartz, C. E., Powell, V. E., Edelen, M. O., Michael, W. (2016). Validating a patient-reported measure of reserve-building activities. Quality of Life Research, 25, 171.
Dillman, D. A., Smyth, J. D., & Christian, L. M. (2014). Internet, phone, mail, and mixed-mode surveys: The tailored design method (4th ed.). Hoboken, NJ: Wiley.
Hanmer, J., Cherepanov, D. (2015). A single question about a respondent’s perceived financial ability to pay monthly bills explains more variance in health utility scores than absolute income and assets questions. Quality of Life Research. 1–5.
Sangha, O., Stucki, G., Liang, M. H., Fossel, A. H., & Katz, J. N. (2003). The self-administered comorbidity questionnaire: A new method to assess comorbidity for clinical and health services research. Arthritis Care & Research, 49(2), 156–163.
WHO. (2004). International statistical classification of diseases and health related problems (The) ICD-10. Geneva: World Health Organization.
Hays, R. D., Bjorner, J. B., Revicki, D. A., Spritzer, K. L., & Cella, D. (2009). Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Quality of Life Research, 18(7), 873–880.
National Institute of Neurological Disorders and Stroke (2010). User manual for the quality of life in neurological disorders (Neuro-QOL) measures, version 1.0.
Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57, 1069–1081.
Rammstedt, B., & John, O. P. (2007). Measuring personality in one minute or less: A 10-item short version of the Big Five Inventory in English and German. Journal of Research in Personality, 41(1), 203–212.
Muthen, B., & Muthen, L. (1998). Mplus User’s Guide. Los Angeles: Muthen & Muthen.
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55.
Byrne, B. M. (2013). Structural equation modeling with Mplus: Basic concepts, applications, and programming. Abingdon: Routledge.
Samejima, F. (2016). Graded response models. Handbook of item response theory (pp. 95–107). Boca Raton: CRC Press.
Cai, L., Du Toit, S., & Thissen, D. (2011). IRTPRO: Flexible, multidimensional, multiple categorical IRT modeling [Computer software]. Chicago, IL: Scientific Software International.
Embretson, S. E., & Reise, S. P. (2000). Item response theory for psychologists. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.
StataCorp. (2016). Stata Statistical Software: Release 14. College Station, TX: StataCorp LP.
Scarmeas, N., Levy, G., Tang, M. X., Manly, J., & Stern, Y. (2001). Influence of leisure activity on the incidence of Alzheimer’s disease. Neurology, 57(12), 2236–2242.
Lindstrom, H. A., Fritsch, T., Petot, G., Smyth, K. A., Chen, C. H., Debanne, S. M., et al. (2005). The relationships between television viewing in midlife and the development of Alzheimer’s disease in a case–control study. Brain and Cognition, 58(2), 157–165.
Huber, M., Knottnerus, J. A., Green, L., van der Horst, H., Jadad, A. R., Kromhout, D., et al. (2011). How should we define health? British Medical Journal, 343, d4163.
Schwartz, C. E., & Daltroy, L. H. (1999). Learning from unreliability: The importance of inconsistency in coping dynamics. Social Science and Medicine, 48(5), 619–631.
Richards, M., & Deary, I. J. (2005). A life course approach to cognitive reserve: A model for cognitive aging and development? Annals of Neurology, 58, 612–622.
Bagozzi, R. P., & Yi, Y. (1988). On the evaluation of structural equation models. Journal of the Academy of Marketing Science, 16(1), 74–94.
Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39–50.
We are grateful to Maria Orlando Edelen, Ph.D., Brian C. Healy, Ph.D., Adri van der Wurff, Ph.D., and David Eton, Ph.D. for helpful discussions; Randi Andenaes, RN, Ph.D., Inger Utne, RN, Ph.D., Nina Misvaer, RN, PHN, and other faculty from the Oslo and Akershus University College in Oslo, Norway, and Pythia Nieuwkerk, Ph.D., from the Academic Medical Center, University of Amsterdam, for help translating, piloting the measure, and suggesting changes to ensure its cross-cultural applicability. We gratefully acknowledge Victoria Powell, M.P.H., for assistance with data management and statistical programming early in the course of this study. Drs Sprangers and Nieuwkerk were supported by a grant from the Netherlands Organization for Scientific Research (NWO 310-20-003).
How to Obtain the Reserve-Building Measure
The interested reader can obtain the DeltaQuest Reserve-Building Measure and further information about item parameters by contacting the first author (CES) and licensing the tool from DeltaQuest Foundation for a specified use and term. License fees vary, depending on the nature of the licensee organization (e.g., academic, not-for-profit, for-profit). Such fees are used to fund further measurement development by DeltaQuest Foundation for use in clinical research and practice.
Conflict of interest
All authors declare that they have no potential conflicts of interest.
About this article
Cite this article
Schwartz, C.E., Michael, W., Zhang, J. et al. Assessing reserve-building pursuits and person characteristics: psychometric validation of the Reserve-Building Measure. Qual Life Res 27, 423–436 (2018). https://doi.org/10.1007/s11136-017-1694-2
- Person characteristics
- Quality of life