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The Mediating Role of Cortical Atrophy on the Relationship between the Resilience Index and Cognitive Function: Findings from the Healthy Brain Initiative

Published online by Cambridge University Press:  26 August 2025

R. Ezzeddine ,
D. Oshea ,
S. Camacho ,
L. Besser ,
M. Tolea ,
J. Galvin ,
C. Galvin ,
L. Wang  and
G. Gibbs
R. Ezzeddine*
Affiliation:
Psychiatry
D. Oshea
Affiliation:
Neurology
S. Camacho
Affiliation:
Neurology
L. Besser
Affiliation:
Neurology
M. Tolea
Affiliation:
Neurology
J. Galvin
Affiliation:
Neurology
C. Galvin
Affiliation:
Neurology
L. Wang
Affiliation:
University of Miami, Miami, United States
G. Gibbs
Affiliation:
Neurology
*
*Corresponding author.

Abstract

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Introduction

Background: Lifestyle factors are linked to differences in brain aging and risk for Alzheimer’s disease, underscored by concepts like ‘cognitive reserve’ and ‘brain maintenance’. The Resilience Index (RI), a composite of 6 factors (cognitive reserve, physical and cognitive activities, social engagement, diet, and mindfulness) provides such a holistic measure.

Objectives

This study aims to examine the association of RI scores with cognitive function and assess the mediating role of cortical atrophy.

Methods

Baseline data from 113 participants (aged 45+, 68% female) from the Healthy Brain Initiative were included. Life course resilience was estimated with the RI, cognitive performance with Cognivue®, and brain health using a machine learning derived Cortical Atrophy Score (CAS). Mediation analysis probed the relationship between RI, cognitive outcomes, and cortical atrophy.

Results

In age and sex adjusted models, the RI was significantly associated with CAS (β= -0.25, p = 0.006) and Cognivue® scores (β= 0.32, p < 0.001). The RI-Cognivue® association was partially mediated by CAS (β= 0.07; 95% CI [0.02, 0.14]).

Conclusions

Findings revealed that the collective effect of early and late-life lifestyle resilience factors on cognition are partially explained by their association with less brain atrophy. These findings underscore the value of comprehensive lifestyle assessments in understanding the risk and progression of cognitive decline and Alzheimer’s disease in an aging population.

Disclosure of Interest

R. Ezzeddine: None Declared, D. Oshea: None Declared, S. Camacho: None Declared, L. Besser: None Declared, M. Tolea: None Declared, J. Galvin Employee of: Cognivue (Chief Scientific Officer of Cognivue). Cognivue devices are used for research conducted at the center., C. Galvin: None Declared, L. Wang: None Declared, G. Gibbs: None Declared

Information

Type
Abstract
Information
European Psychiatry , Volume 68 , Special Issue S1: Abstracts of the 33rd European Congress of Psychiatry , April 2025 , pp. S830
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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