The brain remains dynamic even in older age and can benefit from mental exercises. Thus, it is important to understand the concepts of positive and negative neuroplasticity and how these mechanisms either support or detract from cognitive reserve. This article provides a brief review of these key concepts using four exemplary studies that clearly show the effects that these neurological mechanisms exert on cognitive reserve and cognitive functioning. From this review, a working knowledge of how neuroplasticity and cognitive reserve are expressed in patients will be provided along with how this information can be incorporated into nursing practice and research. Copyright © 2012 American Association of Neuroscience Nurses.