The role of cognitive reserve in traumatic brain injury: a systematic review of observational studies

ABSTRACT

Objective

Evaluate the role of cognitive reserve (CR) on cognitive and physical sequelae in traumatic brain injury (TBI).

Methods

A comprehensive search strategy was conducted in four databases in English and Spanish in the last 12 years (2011–2023). Inclusion criteria: original cross-sectional and longitudinal studies whose main or secondary objective was to evaluate the effect of CR in adult patients with TBI. PRISMA guidelines were used to report the search and selection method and STROBE checklist was used to evaluate the quality of studies.

Results

Eighteen observational studies were included in this review. Multiple sources of variability were observed: number of patients, time of evolution, severity of the TBI, type of CR proxy, cognitive assessment instrument, etc. However, the most commonly used indicators of CR were premorbid IQ and educational attainment. A positive and consistent association between CR and performance on cognitive tests after injury was found.

Conclusions

CR has a consistent positive effect on cognition and on some other aspects of recovery in traumatic brain injury. In future studies, it will be necessary to promote the use of CR indices based on various indicators and explore the effects of CR on other aspects related to the recovery of brain trauma.

KEYWORDS:

• Traumatic brain injury
• cognitive reserve
• cognition
• rehabilitation
• disability

Acknowledgments

To Dr Paola Toussaint-González for her invaluable work in reviewing the English wording of the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

GMG and QRC performed the bibliographic search and participated in the initial analysis of the selected articles. GMG and PCM performed the final analysis of the information and results, as well as the analysis of the quality of the studies. GMG, PCM and MASC made the final discussion of the results and the final composition of the article.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02699052.2024.2304876.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.