Cognitive reserve (CR) refers to the brain's ability to compensate for damage or pathology, allowing individuals to maintain cognitive function despite brain changes. It is distinguished from brain reserve, which relates to anatomical differences. Epidemiological studies suggest that factors like education, occupation, and leisure activities are associated with lower dementia risk, indicating they may enhance CR. CR has implications for diagnosis and prognosis in clinical practice. CR is influenced by both brain structure and cognitive flexibility. Neural reserve refers to individual differences in brain networks, while neural compensation involves using alternative brain regions to compensate for damage. Studies show that higher CR is linked to better clinical outcomes. Neuroimaging studies support this, showing that higher education is associated with greater cognitive function despite similar pathology. Interventions to enhance CR include aerobic exercise and cognitive training. Aerobic exercise improves brain plasticity, potentially boosting reserve. Cognitive training, such as complex video games, may enhance executive control and cognitive efficiency. A study on the game "Space Fortress" showed that training with emphasis change improved cognitive performance in older adults. CR has practical implications for clinical evaluation, as it can influence the rate of cognitive decline in Alzheimer's disease. Biomarkers like PET scans can detect pathology even without cognitive impairment. However, integrating CR into clinical practice remains challenging due to the need for long-term studies. While CR is beneficial, it should not be presented as a proven treatment for dementia. Future research should explore combining interventions like exercise and cognitive training to enhance both brain reserve and CR. The concept of CR is applicable beyond dementia, influencing understanding of brain pathology in various conditions. Overall, CR provides a framework for understanding individual differences in resilience to brain changes and offers potential for interventions to promote healthy aging.Cognitive reserve (CR) refers to the brain's ability to compensate for damage or pathology, allowing individuals to maintain cognitive function despite brain changes. It is distinguished from brain reserve, which relates to anatomical differences. Epidemiological studies suggest that factors like education, occupation, and leisure activities are associated with lower dementia risk, indicating they may enhance CR. CR has implications for diagnosis and prognosis in clinical practice. CR is influenced by both brain structure and cognitive flexibility. Neural reserve refers to individual differences in brain networks, while neural compensation involves using alternative brain regions to compensate for damage. Studies show that higher CR is linked to better clinical outcomes. Neuroimaging studies support this, showing that higher education is associated with greater cognitive function despite similar pathology. Interventions to enhance CR include aerobic exercise and cognitive training. Aerobic exercise improves brain plasticity, potentially boosting reserve. Cognitive training, such as complex video games, may enhance executive control and cognitive efficiency. A study on the game "Space Fortress" showed that training with emphasis change improved cognitive performance in older adults. CR has practical implications for clinical evaluation, as it can influence the rate of cognitive decline in Alzheimer's disease. Biomarkers like PET scans can detect pathology even without cognitive impairment. However, integrating CR into clinical practice remains challenging due to the need for long-term studies. While CR is beneficial, it should not be presented as a proven treatment for dementia. Future research should explore combining interventions like exercise and cognitive training to enhance both brain reserve and CR. The concept of CR is applicable beyond dementia, influencing understanding of brain pathology in various conditions. Overall, CR provides a framework for understanding individual differences in resilience to brain changes and offers potential for interventions to promote healthy aging.