Xu H, et al. - In this cohort study involving 1,602 dementia-free older adults, researchers tested the premise that high lifespan cognitive reserve (CR) correlates with a decline in clinical dementia risk and assessed the strength of this connection in the presence of brain pathologies utilizing data from a long-term community-based cohort study where people donated their brains for autopsy. Using Cox regression models or logistic regression, the relationship of lifespan CR with dementia or brain pathologies was estimated. Investigators found that high lifespan CR is linked to a reduction in risk of dementia, even in individuals with elevated Alzheimer disease (AD) and vascular pathologies. The results indicate that accumulative, lifelong learning and mentally stimulating activities that enhance CR may be a feasible strategy to prevent dementia, even in people with high AD or vascular pathologies.