Research Reports - Cognitive reserve components as expressed in traumatic brain injury

J Int Neuropsychol Soc. 2013 Apr 11:1-8

Levi Y, Rassovsky Y, Agranov E, Sela-Kaufman M, Vakil E

Traumatic brain injury (TBI) is the most common cause of brain damage, resulting
in long-term disability. The "reserve" construct has been proposed to account for
the reported mismatch between brain damage and its clinical expression. Although
numerous studies have used various measures thought to reflect this construct,
few studies have examined its underlying structure in clinical populations, and
no studies have systematically studied this construct in TBI. In the present
study, structural equation modeling technique was used to evaluate several models
hypothesized to represent cognitive reserve (CR) in TBI. A broad range of data
typically reported in the literature as representing CR was collected from 89
individuals who sustained moderate-to-severe TBI. Analyses revealed a best
fitting model that consisted of three separate factors representing premorbid
intelligence, socioeconomic status and leisure activity, with distinct pattern of
associations among the three factors. Findings provide empirical support for the
notion of a multi-factorial CR and suggest a coherent framework for further

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