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Cognitive Reserve and the Relationship Between Depressive Symptoms and Awareness of Deficits in Dementia

Received November 29, 2004; revised March 18, 2005; accepted March 18, 2005. From Brown Medical School, Department of Psychiatry and Human Behavior, Providence, Rhode Island; Rhode Island Hospital Neuropsychology Program, Providence, Rhode Island; and the Miriam Hospital. Address correspondence to Dr. Tremont, Rhode Island Hospital Neuropsychology Program, 593 Eddy St., Providence, RI 02903; gtremont{at}lifespan.org (E-mail).

Depression and low cognitive reserve are linked to impaired awareness in dementia, although their relative contributions are unknown. The authors investigated the impact of depressive symptoms and cognitive reserve on awareness in questionable and mild dementia. Sixty-six patients completed measures of cognitive reserve, awareness, and depressive symptoms. Cognitive reserve and its interaction with depressive symptoms accounted for significant proportions of variance in awareness; depressive symptoms alone did not. Depressive symptoms and awareness were positively related in high, but not low, cognitive reserve groups. Findings suggest cognitive reserve moderates the depression/awareness relationship in dementia, which may explain previously discrepant findings.

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