J. A. HERRERA PINO ET AL.
mean score obtained by the CRQHS group in the BNT was
22.68 (sd = 4.27), while the corresponding value obtained by
the CRQLS group was 16.87 (sd = 3.94). The difference be-
tween these means was found to be statistically significant at
the level of p < 0.000.
The mean score obtained by the CRQHS group in the first
administration of the list of words of the Rey Auditory Verbal
Learning Test (RAI) was 4.28 (sd = 1.44), while the mean score
for the CRQLS group was 3.71 (sd = 1.08). The difference
between these two means was not found to be statistically sig-
nificant (p = 0.083). In the fifth administration of the list of
words of this instrument (RAV), the mean score value for the
CRQHS group was 7.86 (sd = 2.12) and for the CRQLS group
the mean score was 6.00 (sd = 2.40). This difference in mean
values was found to be significant at the level of p = 0.002.
The mean score obtained by the CRQHS group in the de-
layed (20 minutes) administration of the list of words of the
Rey Auditory Verbal Learning Test (RAD) was 5.87 (sd =
2.70), with a corresponding mean value of 4.40 (sd = 2.48) for
the CRQLS group. The difference between these means was
found to be statistically significant at the level of p = 0.027.
Relative to the Rey Osterrieth Complex Figure Test, the
findings were as follows. The CRQHS group obtained a mean
score of 30.23 (sd = 4.44) in the copy administration (ROC).
The CRQLS group obtained an average score of 22.01 (sd =
7.40). The difference between these means was found to be
highly significant (p < 0.000). In the delayed (30 minutes) re-
call administration of this instrument (ROM), the CRQHS
group obtained a mean value of 10.71 (sd = 5.40), and the
CRQLS group obtained a mean value of 6.29 (sd = 3.35). Once
more, the difference between these two means was found to be
highly significant (p < 0.000).
In the Revised Benton Visual Retention Test (BVR), the
CRQHS group obtained an average score of 3.75 (sd = 1.79).
The corresponding value for the CRQLS group was 2.12 (sd +
1.56). The difference between these two means was also found
to be highly significant (p < 0.000).
Discussion
It is evident, on the bases of the results described above, that
the level of cognitive reserve attained by the participants in this
study has a significant and measurable impact on their neuro-
cognitive status, as measured by an eclectic battery of neuro-
psychological instruments. This impact was seen clearly on the
attentional and incidental memory abilities measured by the
written and oral administrations of the Symbol Digit Test. The
results obtained in this study also revealed the impact of cogni-
tive reserve on the verbal fluency and word finding abilities
measured by the Controlled Oral Word Association Test.
The level of cognitive reserve was also noted to have an im-
pact on the naming function of language, as measured by the
Boston Naming Test. In addition to this, the level of cognitive
reserve was also found to have an impact on the visual con-
structional praxis abilities measured by the copy administration
of the Rey Osterrieth Complex Figure Test, as well as the inci-
dental memory functions assessed by the delayed memory ad-
ministration of this instrument.
On the other hand, the impact of the level of cognitive re-
serve, as measured by the CRQ did have a clear impact on tasks
in which memory was an important function. The results of the
recall of the initial presentation of the supra-span list of words
(RAI) of the Rey Auditory Verbal Learning Test did not differ
significantly between the two groups of patients.
Even though the mean values obtained by both groups in the
fifth administration of the word list (RAV) and the delayed
administration (RAD) showed statistical significance, the actual
values differed by less than two (2) points. It is very difficult to
make clinical decisions on the bases of such a narrow margin of
difference. The same may be said of the visual memory func-
tions assessed by the Revised Benton Visual Retention Test
(BVR).
The interpretation of these findings brings out the ever pre-
sent concern of the difference between statistical significance
and clinical significance. Whereas these results show statistical
significance, once again, it is very difficult to translate them
into the clinical setting.
It should be noted that both groups did not perform well in
measures related to memory processes. One possible explana-
tion is the fact that these patients can be characterized as pre-
senting what has been described as mild cognitive impairment
of the amnestic type (now referred to as minor neurocognitive
disorder), as they were referred to the Cognitive Health Pro-
gram of MCCI, by their primary care physicians, for having
reported to them memory difficulties to begin with..
Conclusion and Recommendations
The findings of this study clearly support the initial premise
that there are things that can be done throughout the life cycle,
to improve overall cognitive functioning in the later years of
life. It is important to note that the sample included in this study
is a referred sample, that is, patients referred for neuropsy-
chological evaluation due to memory complaints. In this regard,
it would be important to explore the impact of cognitive reserve
on neuropsychological status of healthy, non-referred individu-
als, as well. It would also be important to replicate this study
with patients that have begun to show symptoms of probable
Alzheimer’s disease.
The knowledge gained through this research can help in the
development of life long strategies to improve or increase cog-
nitive reserve. It can also point the way to the need for devel-
oping and implementing neurobehavioral interventions to
lessen the impact of the aging process or the presence of medi-
cal conditions that may accelerate cognitive decline and result
in functional impairments.
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