Riserva cognitiva

Hobbies help get better, according to a study conducted on people with Huntington's disease.

Time spent on hobbies throughout life helps to better cope with loss of cognitive function and independence in people with early stage Huntington's disease.


The study, entitled Cognitive Reserve in Early Manifest Huntington Disease Patients: Leisure Time Is Associated with Lower Cognitive and Functional Impairment, was recently published in the Journal of Personalized Medicine, in the special issue on Huntington's disease, edited by prof. Ferdinando Squitieri.

It was conducted by the IRCCS Casa Sollievo della Sofferenza and by the LIRH Foundation, in collaboration with the Sant’Andrea Hospital in Rome and the IRCCS Carlo Besta in Milan.

According to the theory of cognitive reserve, the evolution of neurodegenerative diseases in people with a high level of education or with an active lifestyle would be milder than in others. It seems, in fact, that people with a greater intellectual background and experience are able to better tolerate more severe brain damage, before developing symptoms of cognitive impairment or dementia.

But what is the cognitive reserve? The cognitive reserve is a sort of 'warehouse' of resources that our brain accumulates over time, which allows it to sustain brain damage and maintain adequate functioning over time. Faced with the same loss of neurons (brain cells) - which may be due to normal aging, chronic degenerative diseases or trauma - two similar individuals will have a different ability to recover and maintain adequate functioning, depending on the greater or lesser degree. cognitive reserve capacity.

Two scientific models describe it: the passive and the active one. The first hypothesizes that the amount of "brain matter" (determined by the volume of the brain, the number of neurons, etc.) available to the individual constitutes a barrier to the development of neurological diseases. The active model, on the other hand, hypothesizes that the cognitive reserve is the ability of the nervous system to cope with any brain damage by using existing neural networks more efficiently or by activating additional brain regions. In both cases, the cognitive reserve can be strengthened by factors such as education, work activity or engagement in recreational activities.

Some preliminary studies on Huntington's disease seem to document how individuals with greater cognitive reserve have less brain volume loss and greater neuronal connectivity, which is associated with a slower decline in some specific cognitive functions. The brain is, therefore, able to reorganize its own structure, functionality and interconnection networks (brain plasticity) in response to internal and external changes; this could represent a potential protective factor and therefore a goal in the prevention of many neurodegenerative diseases.

The study evaluated the impact of cognitive reserve on autonomy of 75 'early manifest' patients with Huntington's disease participating in the ENROLL-HD study in Italy, by using an internationally validated questionnaire, the Cognitive Reserve Index questionnaire (CRIq), which investigates: level of education, work and leisure activities. 

It emerged that the impact of HD on cognitive abilities and autonomy in daily life is not so much dependent on the cognitive reserve linked to the education level or the work activity, but rather on the one linked the activities carried out in free time. In other words, to hobbies. In the group of patients with high cognitive reserve, the time devoted to activities such as reading, theater, gardening, music, etc. produced a specific cognitive reserve, which is associated with a lower severity of disease progression.

The cognitive reserve is therefore a candidate as a possible neuroprotective factor. Cognitive physical function and exercise improve neuronal plasticity by improving the connections between brain areas.

"From a scientific point of view this result is extremely interesting - Ferdinando Squitieri, responsible for the study - because it identifies an environmental risk factor that affects the course of Huntington's disease, apparently regardless of the genetic mutation effect".

Our study supports, for the first time, the hypothesis that free time plays a prominent role, with respect to education and work, in preventing cognitive and functional degeneration. When formal education ends and work becomes more routine, the activities carried out in free time allow a continuous mental exercise and a fundamental stimulation for the maintenance and further development of the cognitive reserve. Cognitive stimulation and physical exercise increase neuroplasticity and promote neurogenesis, therefore the cognitive reserve is not fixed over time, but it is modifiable even in old age.

The main activities evaluated in the questionnaire are: Reading of newspapers and weeklies - Household activities (cooking, washing) - Driving (except bicycles) - Leisure activities (sports, hunting, chess, puzzles, numismatics, etc.) - Use of new technologies (computers, navigators, smartphones, Internet etc.) - Social activities (after-work, clubs, political parties, etc.) - Cinema, theater - Gardening, DIY, knitting, sewing, embroidery etc. - Volunteering - Artistic activities (music, singing, acting, painting, writing, etc.) - Exhibitions, concerts, conferences - Multi-day trips - Reading books - Pet care


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