Abstract
Background: Evidence shows that Cognitive Reserve (CR) plays a protective role in neurological
and acute/chronic diseases. Its effect on depressive mood, however, is still unclear, and is an issue
that may be relevant in a hospital setting, since depressive mood has been associated with worse
clinical outcomes. We aimed to explore the relationship between CR and depressive mood in older
inpatients, including evaluation of gender- and age-related differences. Methods: This crosssectional study involved 86 inpatients aged ≥65 years with a Mini-Mental State Examination ≥
15. Participants underwent a multidimensional evaluation that included measuring CR with the
Cognitive Reserve Index questionnaire (CRIq), which is divided into three sections (Education,
Working Activity and Leisure Time). Depressive mood was assessed with the 15-item Geriatric
Depression Scale (GDS-15). The relationship between CR and GDS was evaluated by linear
regressions adjusted for potential confounders. Results: Significant associations between CR and
GDS scores were found in the total sample (β=-0.03 SE=0.02, p=0.047), especially in men (β=-
0.05 SE=0.02, p=0.005) and in individuals aged<85 years (β=-0.07 SE=0.03, p=0.01). Of the
individual CRI sections, CRI-Leisure Time was associated with GDS in the total sample (β=-0.03
SE=0.01, p=0.03), in men (β=-0.03 SE=0.01, p=0.03), and in participants <85 years (β=-0.05
SE=0.02, p=0.01). Conclusions: CR seems to be inversely associated with depressive mood in
older inpatients. This relationship is particularly marked for CR related to Leisure Time, which
may be modifiable even in older age through social support and interaction
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