Costantino Iadecola, MD: Cognitive Reserve in Alzheimer Disease

“Doing, for example, an amyloid scan or a tau scan to detect some of the things that could once only be seen in pathology—now we can do that early. The problem is that a lot of normal people, the non-cognitively impaired, also seem to have those things in the brain.”

Advancements in imaging technology and research have allowed for physicians treating patients with Alzheimer disease to now detect the presence of proteins which are essential to the pathology of the disease much earlier than ever before. This has made diagnosing Alzheimer disease easier and allowed for treatment to begin sooner—a vital step.

Although, there is a remaining issue. Many patients who are cognitively normal also have levels of amyloid beta in their brains. The difference is that they have a larger cognitive reserve, hinting at, potentially, a better ability for their brains to maximize the performance of damaged resources. As Costantino Iadecola, MD, would point out, this is a complicating issue.

To discuss how to make the decision about who will end developing Alzheimer and who will not when amyloid buildup occurs, the Anne Parrish Titzell Professor of Neurology and Neuroscience at Weill Cornell Medicine’s Feil Family Brain and Mind Research Institute sat down with NeurologyLive for an interview.