Aging, brain disease, and reserve: Implications for delirium

Richard N. Jones, Tamara G. Fong, Eran Metzger, Samir Tulebaev, Frances M. Yang, David C. Alsop, Edward R. Marcantonio, L. Adrienne Cupples, Gary Gottlieb, Sharon K. Inouye

Research output: Contribution to journalReview articlepeer-review

90 Scopus citations


Cognitive and brain reserve are well studied in the context of age-associated cognitive impairment and dementia. However, there is a paucity of research that examines the role of cognitive or brain reserve in delirium. Indicators (or proxy measures) of cognitive or brain reserve (such as brain size, education, and activities) pose challenges in the context of the long prodromal phase of Alzheimer disease but are diminished in the context of delirium, which is of acute onset. This article provides a review of original articles on cognitive and brain reserve across many conditions affecting the central nervous system, with a focus on delirium. The authors review current definitions of reserve. The authors identify indicators for reserve used in earlier studies and discuss these indicators in the context of delirium. The authors highlight future research directions to move the field ahead. Reserve may be a potentially modifiable characteristic. Studying the role of reserve in delirium can advance prevention strategies for delirium and may advance knowledge of reserve and its role in aging and neuropsychiatric disease generally.

Original languageEnglish (US)
Pages (from-to)117-127
Number of pages11
JournalAmerican Journal of Geriatric Psychiatry
Issue number2
StatePublished - Feb 2010
Externally publishedYes


  • Brain reserve
  • Cognitive reserve
  • Delirium
  • Dementia
  • Reserve

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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