Current and Retrospective Cognitive Reserve Survey (2CR)

Abstract

The Current and Retrospective Cognitive Reserve Survey (2CR; Borella et al., 2023) was created to quantify cognitive reserve (CR) proxies using a multidimensional, “life stage-dependent” framework that includes both current (CRc) and retrospective (CRr) statuses. The scale’s content was developed from existing CR questionnaires and a thorough review of the literature on healthy aging and cognition. The 25-item 2CR was evaluated in an Italian sample of individuals over 55 years of age. The results of factor analysis and validity for these items were reported.

Keywords

Retrospective Cognitive Reserve; Current Cognitive Reserve; Aging; Family Engagement; Social Engagement; Leisure Activity; Socio-Economic Status; Religious/Spiritual Activity; Developmental Measures.

Authors

Borella, Erika; Ghisletta, Paolo; Carbone, Elena; Aichele, Stephen

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Purpose

The purpose of this survey is to assess classical CR proxies (socio-economic status, engagement in leisure and social activities) and other dimensions of potential importance (family engagement, religious/spiritual activity) both currently (CRc; in later adulthood) and retrospectively (CRr; as recalled from younger adulthood).

Validity

Convergent and Discriminant Validity: With respect to the demographic measures, chronological age was weakly negatively correlated with current leisure activity and social engagement and was weakly negatively correlated with retrospective leisure activity, socio-economic status (SES: education), and global CR. Chronological age was moderately negatively associated with current family engagement. Men had weakly/moderately lower religious activity, currently and retrospectively, than women. Men had weakly/moderately higher current SES (occupation) and family engagement, and weakly/moderately higher retrospective social engagement and CR, than women.

Reliability

No data is Available.

Factor Analysis

Confirmatory Factor Analysis: Overall fit was acceptable across all models based on established cutoff criteria (Hu & Bentler 1999). However, the residual covariance matrix (theta) was non-positive definite for the three-level model with a single global CR factor. A formal test of change in model fit across the three-level models (Δχ2 = 14, df = 1, p < 0.001) further confirmed selection of the model with two global CR factors (CRc, CRr) over the model with a single global CR factor. Analyses confirmed a three-level factor structure with two global CR factors (CRc and CRr) at the top level, dimensional CR factors (socio-economic status, family engagement, leisure activity, social engagement, and religious/spiritual activity) at mid-level, and observed items at the lowest level.

Instrument: Current and Retrospective Cognitive Reserve Survey (2CR)

Test Type: Original Inventory/Questionnaire

Format: All response-level items are scaled 0–4, except for educational level, which is scaled from 1 to 7 to cover all of the major educational attainment levels provided by the Italian education and training system (higher scores = higher level of education completed). For the items assessing the engagement in leisure, social, and spiritual/religious activities, participants are asked to rate their frequency of engagement with each of the activities choosing the following options: never, seldom (yearly), sometimes (monthly), often (weekly), always (daily). The structure of the 2CR corresponds to a three-level factor model, with general current and retrospective CR (CRc and CRr) at the top level, i.e., at level-3, the above-described CR dimensions as latent constructs at level-2, and observed items at level-1. All level-1 items except for indicators of socio-economic status are obtained as composite scores of sets of two or more items.

Language Available: Italian

Population Group: Human; Male; Female

Age Group: Adulthood (18 yrs & older); Middle Age (40-64 yrs); Aged (65 yrs & older); Very Old (85 yrs & older)

Population Details: Respondents: Community-Dwelling Italian Adults (Ages 55–90 Years), Location: Italy

Test Methodology: Test Validity; Convergent Validity; Discriminant Validity; Factor Analysis; Confirmatory Factor Analysis

Keywords

Cognitive Reserve

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Authors Including

Author ORCID Identifier:
Ghisletta, Paolo: http://orcid.org/0000-0001-7731-2406
Carbone, Elena: http://orcid.org/0000-0003-4141-3824
Aichele, Stephen: http://orcid.org/0000-0002-3397-7921

Affiliation:
Borella, Erika: University of Padova, Department of General Psychology
Ghisletta, Paolo: UniDistance Suisse
Carbone, Elena: University of Padova, Department of General Psychology
Aichele, Stephen: Colorado School of Public Health, Department of Epidemiology

Email Addresses:
Borella, Erika: [email protected]
Aichele, Stephen: [email protected]

Correspondence Address:
Borella, Erika: [email protected]

Permissions & Fee and Test Year

Permissions: May use for Research/Teaching
Commercial: No
Fee: No
Test Year: 2023
Web Site: creativecommons.org/licenses/by/4.0/

References

Borella, E., Ghisletta, P., Carbone, E., & Aichele, S. (2023). The Current and Retrospective Cognitive Reserve (2CR) survey and its relationship with cognitive and mood measures. European Journal of Ageing, 20(1), Article 23. https://doi.org/10.1007/s10433-023-00766-x

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Items of the Current and Retrospective Cognitive Reserve Survey (2CR)

This measure consists of 25 items, with multiple items being comprised of multiple parts.

Subscales: Socio-economic status; Family engagement; Leisure activity; Social engagement; Religious/spiritual activity..

Instructions

The following questions refer to different aspects of your life. After each question you will find a series of alternative answers. Please fill in the option that best represents your choice, by marking the corresponding box with an “X”.

Demographics

• Date:

• Code/ID:

• Sex (M/F):

• Date of birth:

• Age:

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EDUCATION

1. What is the highest level of education you achieved?

   • [ ] Pre-school

   • [ ] Elementary school

   • [ ] Middle school

   • [ ] High school

   • [ ] Bachelor’s Degree

   • [ ] Master’s degree

   • [ ] Doctorate (PhD, MD)

2. How many years of schooling (including pre-school) have you completed? __________

OCCUPATION

1. What type of work have you mostly done in life? (Think about the occupation you had for the longest period of time).

   • [ ] Manual, non-qualified occupation

   • [ ] Manually skilled, qualification required

   • [ ] Non-manual, technical qualification required

   • [ ] Professional or freelance (with university degree)

   • [ ] Director or manager

FINANCIAL WELLBEING

1. How difficult is it for you to get through the month financially?

   • [ ] Not difficult at all

   • [ ] Not very difficult

   • [ ] Difficult

   • [ ] Very difficult

   • [ ] Extremely difficult

FAMILY ENGAGEMENT

1. Are you married/ Do you have a partner? YES – NO

2. Do you have any children? YES – NO
   a) If yes, how many children do you have? __________

3. Do you have any grandchildren? YES – NO
   a) If yes, how many grandchildren do you have? __________

Partnership quality

1. Partner’s status: The following statements concern your current partner (if you have a partner). For each statement, indicate your degree of agreement.

   Response Options: Strongly disagree, Disagree, Neither agree nor disagree, Agree, Strongly agree

   a) My partner has many interests that keep him/her engaged (busy):
   b) My partner, overall, is in good health:
   c) My partner is often in a good mood:
   d) My partner still has a good “mind” (he/she has no memory or attention difficulties):

Connectivity logistics

1. At present, how often do you do the following activities to spend time or keep in touch with family and close friends?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Drive a car or take public transportation
   b) Use a computer, telephone, smart phone, or tablet to communicate

LEISURE ACTIVITY

Recreational exercise

1. At present, how often do you practice the following recreational exercise activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Exercise at the gym
   b) Dancing
   c) Swimming or water aerobics
   Other aerobic exercise (e.g., walking, cycling): __________

Creative expression

1. At present, how often do you practice the following creative activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Playing a musical instrument
   b) Writing
   c) Painting or drawing
   Other creative expression activity: __________

Intellectual stimulation

1. At present, how often do you practice the following leisure activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Reading
   b) Playing chess
   c) Crosswords or other puzzles
   Other games requiring strategy/reasoning: __________

SOCIAL ENGAGEMENT

Volunteering

1. At present, how often do you perform volunteer work in the following settings?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Hospitals or personal care facilities
   b) Schools or other facilities dedicated to young people or children
   c) Any other association with voluntary or charity aims*

Participation in Associations/Clubs

1. At present, how often do you participate socially in the following settings?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Senior clubs, reading groups, associations for the elderly
   b) Political associations or groups
   c) Clubs, groups or associations of professionals (specify*)__________

Public events

1. At present, how often do you practice the following activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Go to the cinema and / or theater and / or concerts
   b) Go to exhibitions and / or museums
   c) Go to conferences, social events, public events

RELIGIOUS / SPIRITUAL ACTIVITY

Individual activities

1. At present, how often do you perform the following religious / spiritual activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Prayer
   b) Meditation

Group activities

1. At present, how often do you participate in the following religious / spiritual activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Rites/ceremonies
   b) Other church or temple community events (dinners, travel, etc.)

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Retrospective Items

The following questions refer to different aspects of your lifestyle when you were younger (specify age range – i.e. 20-35/40 years of age-). After each question you will find a series of alternative answers. Fill in the option that best represent your choice by marking the corresponding box with an “x”.

LEISURE ACTIVITY

Recreational exercise

1. When you were young, how often did you practice the following recreational exercise activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Exercise at the gym
   b) Dancing
   c) Swimming or water aerobics
   Other aerobic exercise (e.g., walking, cycling): __________

Creative expression

1. When you were young, how often did you practice the following creative activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Playing a musical instrument
   b) Writing
   c) Painting or drawing
   Other creative expression activity: __________

Public events

1. When you were young, how often did you practice the following activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Go to the cinema and / or theater and / or concerts
   b) Go to exhibitions and / or museums
   c) Go to conferences, social events, public events

SOCIAL ENGAGEMENT

Volunteering

1. When you were young, how often did you do volunteer work in the following settings?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Hospitals or personal care facilities
   b) Schools or other facilities dedicated to young people or children
   c) Any other association with voluntary or charity aims*

Participation in Associations/Clubs

1. When you were young, how often did you participate socially in the following settings?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Special interest or hobbyist clubs, reading groups
   b) Political associations or groups
   c) Clubs, groups or associations of professionals (specify*)__________

Connectivity logistics

1. When you were young, how often did you do the following to carry out volunteer and association-related activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Drive a car or take public transportation
   b) Use a computer, telephone, smart phone, or tablet to communicate

RELIGIOUS / SPIRITUAL ACTIVITY

Individual activities

1. When you were young, how often did you perform the following religious / spiritual activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Prayer
   b) Meditation

Group activities

1. When you were young, how often did you participate in the following religious / spiritual activities?

   Response Options: Never, Seldom (Yearly), Sometimes (Monthly), Often (Weekly), Always (Daily)

   a) Rites/ceremonies
   b) Other church or temple community events (dinners, travel, etc.)

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Istruzioni

Gentile partecipante, qui di seguito troverà una serie di domande relative a diversi aspetti della sua vita. Dopo ogni domanda troverà una serie di alternative di risposta. Le chiediamo di selezionare l’alternativa che meglio rispecchia la sua scelta, mettendo una crocetta sulla casella corrispondente.

Dati Anagrafici

• Codice partecipante:

• data somministrazione: __ / __ / __

• Data di nascita: __ / __ / __

• Età: ______

• Genere: M F

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SCOLARITÀ

1. Qual è il più alto grado di istruzione che ha raggiunto?

   • [ ] Scuola dell’infanzia

   • [ ] Elementare

   • [ ] Media

   • [ ] Superiore

   • [ ] Laurea triennale

   • [ ] Laurea magistrale

   • [ ] Dottorato di ricerca

2. Quanti anni di scuola (incluso l’asilo) hai completato? __________

OCCUPAZIONE

1. Che tipo di lavoro ha svolto nella sua vita? (Pensi al lavoro che ha svolto per più tempo)

   • [ ] Manuale non qualificato

   • [ ] Manuale qualificato

   • [ ] Qualificato tecnico, non manuale (es. impiegato)

   • [ ] Professionale o libero professionista (con laurea)

   • [ ] Direttore o manager

SITUAZIONE FINANZIARIA

1. Quanto è difficoltoso per lei arrivare a fine mese economicamente?

   • [ ] Per niente

   • [ ] Poco

   • [ ] Abbastanza

   • [ ] Molto

   • [ ] Moltissimo

FAMIGLIA E COINVOLGIMENTO FAMILIARE

1. È sposato/a o ha un/a compagno/a? SÌ – NO

2. Ha figli? SÌ – NO
   a) Se sì, quanti? __________

3. Ha nipoti? SÌ – NO
   a) Se sì, quanti? __________

Qualità delle relazioni

1. Di seguito trova una serie di affermazioni che riguardano il suo partner/compagno-a. Per ognuna di queste indichi il suo grado d’accordo.

   Opzioni di risposta: In completo disaccordo, In disaccordo, Né d’accordo né in disaccordo, D’accordo, Completamente d’accordo

   a) Il mio partner/compagno-a ha vari interessi che lo impegnano:
   b) Il mio partner/compagno-a gode, in generale, di buona salute:
   c) Il mio partner/compagno-a è spesso di buon umore:
   d) Il mio partner/compagno-a ha ancora una buona “mente” (non ha difficoltà di memoria, o di attenzione etc.):

Mezzi per la connessione con la famiglia

1. Attualmente, quanto spesso svolge le seguenti attività per poter passare del tempo e rimanere in contatto con familiari/amici cari?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Guidare la macchina o prendere mezzi pubblici
   b) Usare il computer, il telefono, il cellulare o il tablet per comunicare

TEMPO LIBERO

Attività fisica/ricreativa

1. Attualmente, quanto spesso pratica le seguenti attività fisiche (ricreative)?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Ginnastica
   b) Ballo
   c) Nuoto (nuoto libero, acqua gym)
   Altre attività fisiche/ricreative (es., camminare, andare in bicicletta): __________

Espressione creativa

1. Attualmente, quanto spesso pratica le seguenti attività creative?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Suonare uno strumento musicale
   b) Scrivere
   c) Dipingere o disegnare
   Altre attività creative: __________

Attività mentali

1. Attualmente, quanto spesso pratica le seguenti attività ricreative?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Leggere
   b) Giocare a scacchi
   c) Cruciverba, giochi enigmistici
   Altre attività/giochi che richiedono strategia/ragionamento: __________

COINVOLGIMENTO SOCIALE

Volontariato

1. Attualmente, quanto spesso pratica attività di volontariato, nelle strutture di seguito riportate?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Ospedali o strutture dedicate alla cura della persona
   b) Scuole o altre strutture dedicate a giovani o bambini
   c) Qualsiasi altra associazione ai fini di volontariato o carità*

Partecipazione ad associazioni / club

1. Attualmente, quanto spesso pratica attività sociali, nelle strutture di seguito riportate?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Club senior, gruppi di lettura, associazioni per anziani
   b) Associazioni o gruppi politici
   c) Circoli, gruppi o associazioni di professionisti (specificare il grado di coinvolgimento/mansione svolta*)__________

Eventi pubblici

1. Attualmente, quanto spesso pratica le seguenti attività?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Andare al cinema e/o teatro e/o concerti
   b) Andare a mostre e/o musei
   c) Andare a conferenze, manifestazioni sociali, eventi pubblici

SPIRITUALITÀ

Attività individuali

1. Attualmente, quanto spesso pratica le seguenti attività religiose/spirituali?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Pregare in privato
   b) Meditare

Attività collettive / di comunità

1. Attualmente, quanto spesso partecipa alle seguenti attività religiose/spirituali?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Riti / cerimonie
   b) Altri eventi della propria comunità religiosa (cene, viaggi etc)

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Items Retrospettivi

Di seguito troverà una serie di domande relative al suo stile di vita quando era più giovane (specificare l’età, ad es. 20-35/40 anni). Dopo ogni domanda troverà una serie di alternative di risposta. Le chiediamo di selezionare l’alternativa che meglio rispecchia la sua scelta, mettendo una crocetta sulla casella corrispondente.

TEMPO LIBERO

Attività fisica/ricreativa

1. Da giovane, quanto spesso praticava le seguenti attività fisiche (ricreative)?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Ginnastica
   b) Ballo
   c) Nuoto (nuoto libero, acqua gym)
   Altre attività fisiche/ricreative (es., camminare, andare in bicicletta): __________

Espressione creativa

1. Da giovane, quanto spesso praticava le seguenti attività creative?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Suonare uno strumento musicale
   b) Scrivere
   c) Dipingere o disegnare
   Altre attività creative: __________

Eventi pubblici

1. Da giovane, quanto spesso praticava le seguenti attività?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Andare al cinema e/o teatro e/o concerti
   b) Andare a mostre e/o musei
   c) Andare a conferenze, manifestazioni sociali, eventi pubblici

COINVOLGIMENTO SOCIALE

Volontariato

1. Da giovane, quanto spesso praticava attività di volontariato, nelle strutture di seguito riportate?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Ospedali o strutture dedicate alla cura della persona
   b) Scuole o altre strutture dedicate a giovani o bambini
   c) Qualsiasi altra associazione ai fini di volontariato o carità*

Partecipazione ad associazioni / club

1. Da giovane, quanto spesso praticava attività sociali, nelle strutture di seguito riportate?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Club senior, gruppi di lettura, associazioni per anziani
   b) Associazioni o gruppi politici
   c) Circoli, gruppi o associazioni di professionisti (specificare il grado di coinvolgimento/mansione svolta*)__________

Mezzi per svolgere attività

1. Da giovane, quanto spesso svolgeva le seguenti attività per praticare attività di volontariato e associazionismo?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Guidare la macchina o prendere i mezzi pubblici
   b) Usare il computer, il telefono, il cellulare o il tablet per comunicare

SPIRITUALITÀ

Attività individuali

1. Da giovane, quanto spesso praticava le seguenti attività religiose/spirituali?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Pregare in privato
   b) Meditare

Attività collettive / di comunità

1. Da giovane, quanto spesso partecipava alle seguenti attività religiose/spirituali?

   Opzioni di risposta: Mai, Raramente (una volta all’anno), Qualche volta (una volta al mese), Spesso (una volta a settimana), Sempre (tutti i giorni)

   a) Riti / cerimonie
   b) Altri eventi della propria comunità religiosa (cene, viaggi etc)

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Scoring Instructions

Scoring is performed sequentially across the three levels of the CR framework. First, level-1 variables’ scores are calculated as a single number scaled 0-4. This is the most complicated step and is described further below. Next, level-2 scores (domain-specific CR scores) are calculated as averages of the corresponding level-1 scores. Finally, level-3 scores (global CR scores) are calculated as averages of the corresponding level-2 scores. The following instructions pertain to the specific calculations required at each level.

1. Level-1 variables’ scores correspond to one or more survey questions, as follows:

Responses to level-1 items are scaled 0-4, from left-to-right across response categories: e.g.,

Education level (item 1) spans seven (rather than five) response categories. Thus, education level is first scored 0-6, and these scores are then post-multiplied by 2/3 to arrive at a consistent scaling.

Years of schooling is assessed as a categorical variable. For manual scoring, this should be stratified into five ordinal responses (0-4) for consistent weighting with other level 1 variables. E.g., 0-5 years, 6-10 years, 11-15 years, 16-20 years, > 20 years.

Financial wellbeing (item 4) should be reverse scored (e.g., 0=4, 1=3, 2=3, 3=1, 4=0) prior to its inclusion in subsequent calculations.

For unmarried/unpartnered persons, scores for partnership quality items (8a, 8b, 8c, 8d) should be assigned values of 2 (“neither agree nor disagree”).

Scores for level-1 variables based on multiple items (parcels) are calculated as the average of the corresponding items. For example, the level-1 score for current intellectual simulation (is_c) is calculated as the mean of items 12a, 12b, and 12c.

2. Level-2 variables’ scores are calculated as averages of the corresponding level-1 variables’ scores:

3. Level-3 variables’ scores are calculated as averages of the corresponding level-2 variables’ scores:

Important Note: Researchers may optionally exclude religious/spiritual activity items in calculations of global cognitive reserve scores (CR_c, CR_r). Religious practice was used in the initial test sample (during survey development) to be inversely related to cognitive performance but was also related to social class; these two dynamics of religious practice may also function differently across new populations. Hence, the decision of whether to include religious/spiritual activity in total CR scores should be made contingent on the specific research goals, and noted accordingly.