Associations of the LIfestyle for BRAin health index with Cognitive Resilience to neuropathology

Lower LIBRA risk scores at baseline, denoting reduced dementia risk, were linearly associated with higher CR_Levels (mean difference [MD] for 1-point lower in LIBRA=0.04; 95%CI=0.02,0.07) and higher CR_Slope (MD=0.04; 95%CI=0.01,0.06) (Figure 1). When examining the individual LIBRA components simultaneously, cognitively stimulating activities showed the strongest associations with both CR measures (Figure 1). Lastly, in stratified analyses considering six specific neuropathological profiles (no, single, mixed CVD; no, single, mixed neurodegenerative), we found that lower LIBRA scores were associated with higher CR_Levels in participants without CVD (MD=0.06; 95%CI=0.01,0.10), in those with a single CVD (MD=0.05; 95%CI=0.01,0.10) and in those with a single neurodegenerative pathology (MD=0.05; 95%CI=0.03,0.09) (Figure 2). No associations were found for CR_Slope. CONCLUSION: These findings support that prevention programs targeting lifestyle modifications and management of other health-related factors could help to preserve cognitive health in older adults by promoting cognitive resilience to neuropathology. The findings also suggest that older adults with fewer neuropathological insults may see larger improvements in resilience.