2026 ECNP Congress

PS01-1162

Neuropsychological predictors of cognitive reserve in Parkinson's disease and cognitive impairment

África Pérez-Santiago — L. Mendoza-Hernández, L. Alonso Recio, S. Rubio Fernández · Autonomous University of Madrid- Faculty of Psychology, Biology and Health Pshychology Department, Madrid, Spain

2026 ECNP Congress

Introduction

Cognitive Reserve (CR) embodies a theory proposing that the brain recruits pre-existing cognitive strategies to compensate for the consequences of brain damage. Traditionally, it has been assessed via tests including variables such as educational level, occupational complexity and leisure activity engagement. Emerging evidence suggests that language processes may constitute a particularly sensitive index of reserve capacity. The study of CR within the context of neurodegenerative diseases pinpoints the relevance of asses its neuropsychological correlates. In particular, in Parkinson’s disease (PD), cognitive heterogeneity, ranging from intact cognition to mild cognitive impairment, may complicate systematic evaluation. Identifying domain-specific cognitive predictors of CR in PD could contribute to the growing literature in the field of neuropsychology.

This study aims to identify which neuropsychological domains most robustly predict CR across PD patients and the level of cognitive decline.

Methods

A total of 103 spanish participants were included: 70 individuals diagnosed with PD and 33 healthy older adults. CR was assessed using the Cognitive Reserve questionnaire [1], a validated self-report instrument covering educational background, occupational history and cognitively stimulating activities. Neuropsychological assessment comprised a battery evaluating visuospatial function, verbal episodic memory, visual episodic memory, language, attention and executive functions through a range of validated tests. Global cognition was assessed with the Montreal Cognitive Assessment [2]. PD participants were divided into cognitively preserved patients (MoCA > 26) and cognitively impaired PD patients (MoCA < 26). Data analysis mainly included univariate models and hierarchical multiple regression models, controlling for age, sex, educational level and time since diagnosis (the latest only in the PD subgroup). For the results, the unique variance explained by each predictor beyond covariates was quantified as the R² increment (ΔR²). The Benjamini-Hochberg false discovery rate correction was applied.

Results

Regarding the full sample, language measures emerged as the strongest predictors of CR: Boston Naming Test (BNT) [3] (ΔR² = 24.7%, p < .001) and Vocabulary test from the Wechsler scale of Intelligence IV [4] (ΔR² = 21.9%, p. < .001). In the PD group, only BNT (ΔR² = 15.4%, p < .001) and Vocabulary (ΔR² = 8.6%, p= .043) were the valid predictive variables, with time since diagnosis included as a covariate. In PD individuals with cognitive impairment (MoCA < 26), Vocabulary (ΔR² = 27.1%, p = .010), BNT (ΔR² = 22.7%, p = .010), and semantic verbal fluency (ΔR² = 18.4%, p = .025) remained robust predictors. There were no significant predictors in cognitively preserved PD patients (MoCA ≥ 26) or in healthy older adults.

Discussion

These findings highlight language abilities, particularly naming and vocabulary range as the most consistent neuropsychological correlates of CR across clinical contexts. The pattern is especially pronounced in PD patients with cognitive impairment, suggesting that language-based measures may offer added value in CR assessment within neurodegenerative populations. Despite limitations, these findings support the need to incorporate language measures into CR evaluation, as well as the importance of multimethod assessments in neuropsychology.

References

  1. Rami, L., Valls-Pedret, C., Bartrés-Faz, D., Caprile, C., Solé-Padullé, C., Castellví, M., Olives, J., Bosch, B., & Molinuevo, J.L. (2011). Cuestionario de reserve cognitiva. Valores obtenidos de la población sana y con enfermedad de Alzheimer. Revista de Neurología, 52(4), 195-201. https://doi.org/10.33588/rn.5204.2010478
  2. Nasreddine, Z.S., Philips, N.A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J.L., & Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the Americans Geriatrics Society, 53(4), 695-699.
  3. Kaplan, E., Goodglass, H., & Weintraub, S. (2006). Test de Vocabulario de Boston (adaptación española). TEA Ediciones.
  4. Wechsler, D. (2008). Wechsler Adult Intelligence Scale—Fourth Edition (WAIS-IV). Pearson.