The TECHReserve Cohort Study: Technological Engagement for Cognitive Health and Reserve
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ABSTRACT Active engagement with digital technologies, such as the internet and smartphones, may lower risk for Alzheimer’s disease (AD) and its clinical symptoms. For example, our recent meta-analysis aggregated data from 411,430 older adults, showing that engagement with digital technologies halved the odds of developing cognitive impairment or dementia (OR=.42, 95%CI=.35-.52).1 Similar findings that suggest causal effects have emerged from population-based longitudinal studies, controlling for demographic, socioeconomic, and cohort factors. Theory surrounding the protective effects of technology use has been formalized in the Technological Reserve Hypothesis, which asserts that digital engagement increases resistance to cognitive and functional decline by stimulating cognitive complexity, promoting social connection, and facilitating compensatory strategy use. While the Technological Reserve Hypothesis holds great promise, three critical research questions need to be answered. First, it is unclear whether to measure technological reserve as a unitary versus multidomain construct, necessitating study of its factor structure. A second important question is whether technological reserve has independent predictive utility from other established constructs, like cognitive reserve, requiring rigorous longitudinal research. Third, the neurobiological processes that underlie technological reserve have not been identified and compared to those for cognitive reserve, which could be accomplished using functional imaging techniques. To address these three gaps, we will develop the Technological Engagement for Cognitive Health and Reserve (TECHReserve) Cohort. The TECHReserve Cohort will be the first large (n=300) longitudinal study of older adults at risk for AD that includes sufficient data on technological reserve, cognitive reserve, AD biomarkers, and neurocognitive function (objective behavioral and functional magnetic resonance imaging [fMRI] assessments). The current R01 will support baseline and 1-year follow up assessments in this cohort to examine competing measurement structures for technological reserve (Aim 1), test for longitudinal evidence of a technological reserve effect (Aim 2), and determine whether the effects of technological reserve are evident in brain activation patterns (Aim 3). We anticipate that individuals high in technological reserve will demonstrate less cognitive decline in the presence of AD pathology compared to those low in technological reserve. Results of this study will provide critical insights into the role that engagement with digital technologies plays in protecting against AD clinical symptoms. In future R01 research, we will expand the TECHReserve Cohort and extend follow up to assess change and maintenance of technology use in relation to AD biomarker accumulation, functional and structural brain change, and incident cognitive impairment. Ultimately, this work will inform technology-based prevention strategies to reduce AD risk and improve health outcomes for older adults living with neurodegenerative diseases.
