I often talk about the cognitive reserve in my podcast and blog posts. When it is used up, the brain can no longer compensate for any damage that occurs. However, it is more of a concept and not that easy to grasp, this cognitive reserve, and of course it can also be used up in other ways. So it’s time to take a closer look at it. How can you measure it and what do you do with the result? Fortunately, there are a number of training options to counteract the invisible challenges – such as memory lapses, concentration difficulties or slowed thinking. To ensure that cognitive changes do not have a significant impact, it is crucial that our brain has the ability to adapt, remain flexible and continue to function even in the event of damage or disease. The good news? Cognitive reserve is not set at birth. You can actively build and strengthen it over time, even into old age.
Find out what the concept of cognitive reserve really means, how it is measured using the Cognitive Reserve Index Questionnaire (CRIq), and, most importantly, what you can do to protect and boost your brainpower – even if you are struggling with MS-related fatigue or limited time. Whether you are just starting to explore the topic or are looking for new strategies, this guide is designed to help you take a confident step towards mental resilience.
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What Is Cognitive Reserve and Why Is It Important in MS?
Cognitive reserve refers to the brain’s ability to adapt and maintain function despite damage or disease. In the context of Multiple Sclerosis (MS), this reserve can help compensate for neurological damage caused by the disease, potentially delaying or minimizing cognitive symptoms such as memory problems, attention difficulties, or slowed thinking. In essence, a higher cognitive reserve can act as a buffer against the effects of MS on brain function.
What Is the CRIq and How Does It Measure Cognitive Reserve?
The Cognitive Reserve Index questionnaire (CRIq) is a standardized tool used to estimate a person’s cognitive reserve. It is relatively straightforward and non-invasive, typically taking 10-20 minutes to complete. The CRIq assesses three main domains:
Education: Number of years of formal schooling and any additional training or certifications.
Example: A person with 12 years of school and a vocational certification might score higher in this domain.
Working Activity: Complexity and duration of a person’s professional life.
Example: Someone who worked 30 years as an engineer would score higher than someone with a short or low-complexity work history.
Leisure Time: Engagement in cognitively stimulating activities during free time.
Example: Reading books, playing musical instruments, or participating in group hobbies all contribute positively.
Each domain is scored, and a composite index is calculated to reflect overall cognitive reserve.
Example Results: High vs. Low Cognitive Reserve
High Cognitive Reserve: Someone with a university degree, a mentally demanding job, and hobbies like reading, traveling, and playing chess might receive a high CRI score (e.g., 125+), suggesting strong mental resilience.
Low Cognitive Reserve: A person with minimal education, few work years in low-demand roles, and little engagement in mental hobbies might score lower (e.g., below 90), indicating greater vulnerability to cognitive decline.
You can also complete the CRIq conveniently online through the official platform: https://www.cognitivereserveindex.org/choice.php. This allows you to choose between a long or short version, both designed for easy self-assessment. I’ve done it myself and provided my anonymous information to the University of Padua, Italy. It is quite basic, but gives you an idea where you stand.
What Can You Do If Your Cognitive Reserve Is Low?
If your results suggest a lower cognitive reserve, don’t worry — this is not a fixed state. You can actively work to build it up:
Learn new skills (languages, crafts, or instruments)
Engage in mentally challenging tasks (puzzles, strategy games)
Increase social interactions
Pursue lifelong learning (online courses, workshops)
Why Aren’t These Tests Commonly Used in MS Care?
Despite their usefulness, CRIq assessments are not routine in MS care due to time constraints, lack of awareness, or limited clinical resources. However, you can complete the questionnaire yourself to gain insights into your mental resilience.
How Reliable Is a Self-Test and What Are Its Limitations?
Self-testing can give a general idea, but it lacks clinical accuracy and may be biased by self-perception or incomplete information. It should be seen as a starting point rather than a diagnostic tool.
Why Is It Always Worthwhile to Train Cognitive Reserve?
Cognitive reserve protects brain function over time, helping manage not just MS-related changes but also age-related cognitive decline. Training it improves mental agility, coping capacity, and overall quality of life.
You might want to check out this episode / blog article to see, why staying active mentally and physically is always a good idea: #049: CogeX Study Insights for Progressive MS on Cognitive Rehabilitation with Prof. Anthony Feinstein
How Can You Train Cognitive Reserve Effectively?
Mix cognitive, social, and physical activities
Stay curious and keep learning
Balance mentally stimulating habits with rest and wellness practices
Here are different examples to suit various lifestyles:
The Social Butterfly: Join a local club or community group, volunteer, or start a regular meetup with friends for board games or discussions.
The Lifelong Learner: Take online courses, attend local lectures, or dive into documentaries and books on topics that fascinate you.
The Creative Explorer: Try painting, photography, creative writing, or learning a musical instrument — creative expression is powerful cognitive training.
The Home-Based Thinker: If going out is difficult, you can still build cognitive reserve by journaling, listening to educational podcasts, playing logic games on a tablet, or watching thought-provoking films or talks.
The Calm Strategist: Practice mindfulness or meditation, explore brain-training apps, or follow structured home programs that combine relaxation with cognitive tasks.
Do I Need to Train All Areas?
No — choose activities that you enjoy or are curious about. If one area doesn’t appeal to you (like academic learning), focus on others like creative hobbies or volunteering. Flexibility is key.
Why You Shouldn’t Be Disheartened by a Low Starting Score
A low cognitive reserve score is not a judgment. It’s a baseline. It simply highlights where you can begin strengthening your mental resilience. Progress is possible at any age or stage of MS.
How to Start Small (Especially with Fatigue or Limited Time)
Set tiny goals (read 1 page, do 1 puzzle, have a 5-minute chat)
Choose enjoyable, low-pressure activities
Incorporate brain-friendly habits into daily routines (e.g., listen to podcasts while resting)
Celebrate consistency over intensity
In Summary
Understanding and improving your cognitive reserve can be empowering, especially when living with MS. It’s not about perfection, but about giving your brain the best support possible for the road ahead.
More information
If you want to know more about the cognitive reserve, you might want to start with the Wikipedia article which offers further resources as always.
See you soon and try to make the best out of your life,
Nele
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