Individuals with the same neurological conditionsdo not necessarily manifest the same behavioral presentation,which suggests differences in resilience and vulnerabilityamong individuals, a concept known as cognitive reserve. Thisstudy sought to explore the relationship among cognitivereserve, executive functioning, and health and safety judgmentin a sample of older adult inpatients in an extended medicalcare unit at a Veterans Health Administration hospital. Wehypothesized that cognitive reserve, as determined by an estimateof premorbid intellectual ability, would act as a protectivefactor against poor judgment in older adults with executivedysfunction. Participants included 200 Veterans who completeda comprehensive neuropsychological assessment,including measures of health and safety judgment, executivefunctioning, global cognitive functioning, and premorbid intellectualability. After controlling for global cognitive functioning,executive functioning abilities did not have an effect onjudgment abilities among those with high estimated intellectualability. However, executive functioning had a significant effecton judgment abilities among those with low estimated intellectualability. Our results suggest that intact executive functioningis critical for making appropriate health and safetydecisions for patients with lower measured intellectual abilitiesand provide further support for the cognitive reserve model.Clinical implications are also discussed.
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