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건강한 노년과 인지예비능: 생의 과정을 통한 인지 및 병리적 노화의 조절

Life course moderation of cognitive reserve for healthy aging

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초록

인지예비능(Cognitive Reserve; CR)은 노화에 따른 두뇌 변화나 뇌 병리로부터 기대되는 정도보다 더 나은 인지 수행과 기능을 가능하게 하는 개인의 신경심리적 속성을 의미한다. 노화 과정은 뇌 부피나 연결성 감소 등 두뇌 자원의 감소, 뇌 위축 및 신경반이나 신경섬유뭉치의 축적과 같은 병리적 변화를 동반하게 되며, 이에 따라 여러 인지 영역에서의 기능 저하가 유발된다. 생의 과정에서의 다양한 경험을 통해 축적되는 인지예비능은, 이와 같은 노화의 부정적 결과나 병리의 표현을 늦추도록 함으로써 건강한 노년을 영위할 수 있도록 돕는 것이 기존 연구에서 확인되고 있다. 따라서, 급격한 인구 고령화가 진행되는 현대 사회에서 인지예비능의 개념과 기전에 대해 이해하고 이의 축적을 촉진할 수 있는 사회경제문화적 환경을 마련하는 것이 무척 중요하다. 본고에서는 인지예비능의 개념과 이론적 정립 과정, 인지예비능 관련 임상 양상, 기전 및 측정 방법에 대해 선행 연구와 논의에 기초하여 포괄적으로 개괄하고 있다. 또한, 인지예비능의 역동적 측면과 노년기 개입 방안, 한국 사회 특수적 고려사항에 대해서도 함께 논의하였다.

Abstract

Cognitive Reserve (CR) refers to the individual’s neuropsychological properties that enable better cognitive performance than what is expected based on current levels of brain resources or pathology. Aging is often accompanied by pathological changes such as a brain atrophy as well as the accumulation of neural plaques or neurofibrillary tangles, leading to functional decline in various cognitive domains. CR, accumulated through diverse experiences in the life course, serves to delay negative outcomes and pathological manifestations of aging. Consequently, it is crucial to understand the concept and mechanisms of CR in this rapidly aging society. This paper comprehensively reviewed the concept and theoretical framework, clinical manifestations, mechanisms, and measurement methods of CR. Additionally, the dynamic aspects of CR, suggestive interventions during late life, and specific considerations for Korean society were also discussed.

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