Background. The concept of cognitive reserve was introduced in the neurological field to account for the observation of individual discrepancies between the level of brain pathology and the observed cognitive/functional deficits. The notion of brain reserve provides a strong foundation for the recent increase of interest in modifiable risk factors as a strategy for brain health promotion.
Strategies. There is now evidence of protective effects on cognitive decline and dementia for physical activity, Mediterranean diet, cognitive training and social engagement, which may all be considered as contributing to brain and cognitive reserve mechanisms. Besides controlling risk factors, an area of great interest is the possibility to act positively on the reserve by means of active intervention. This possibility is suggested by the results of several cognitive training studies in healthy elderly subjects.
Conclusions. Even modest effects on the age of onset or the rate of cognitive decline would have an enormous positive impact on successful aging at the population level worldwide.