학술논문
Bilingualism Delays Expression of Alzheimer's Clinical Syndrome
Document Type
Report
Source
Dementia and Geriatric Cognitive Disorders. April 1, 2020, Vol. 48 Issue 5-6, p281, 9 p.
Subject
Language
English
ISSN
1420-8008
Abstract
Author(s): Mario F. Mendez (corresponding author) [a,b,c]; Diana Chavez [b]; Golnoush Akhlaghipour [b] Introduction Alzheimer's disease (AD), the most common dementia, is an age-related disorder that has reached epidemic proportions [...]
Objective: To evaluate the effects of bilingualism on the emergence of Alzheimer's clinical syndrome. Background: Studies have proposed an increase in cognitive and neural reserve from the management and control of two languages, with a consequent delayed expression of dementia. Methods: In a clinic with a large immigrant population, we identified 253 patients with probable Alzheimer's disease (AD) with intermediate or high evidence of AD pathophysiological process. These patients were reviewed for demographic variables, native language (L1) other than English, ages of onset and presentation, Mini-Mental State Examination (MMSE), digit spans, word fluencies, naming, and memory. Results: Among these patients, 74 (29.2%) were bilinguals with various L1s (Farsi, Spanish, Chinese, Tagalog, Arabic, others). When compared to the 179 monolingual AD patients, those who were bilingual had significant delays in ages of onset and presentation of approximately 4 years (p = 0.003). These delays persisted despite bilinguals having worse MMSE scores on presentation. There were no significant group differences on other variables except for worse naming in English among bilinguals versus monolinguals. Caregiver/informants reported that 66 (89.2%) of the 74 bilingual AD patients had gradually regressed to the predominant use of their L1. Conclusions: In line with published reports worldwide, we found that bilingualism delays the expression of Alzheimer's clinical syndrome. We also found frequent reversion to the first learned language. These findings suggest that, among bilinguals, the availability of an L1 "back-up" either facilitates compensation or masks emergence of the early symptoms of dementia. Keywords: Age of onset, Language, Dementia, Bilingualism, Alzheimer's disease
Objective: To evaluate the effects of bilingualism on the emergence of Alzheimer's clinical syndrome. Background: Studies have proposed an increase in cognitive and neural reserve from the management and control of two languages, with a consequent delayed expression of dementia. Methods: In a clinic with a large immigrant population, we identified 253 patients with probable Alzheimer's disease (AD) with intermediate or high evidence of AD pathophysiological process. These patients were reviewed for demographic variables, native language (L1) other than English, ages of onset and presentation, Mini-Mental State Examination (MMSE), digit spans, word fluencies, naming, and memory. Results: Among these patients, 74 (29.2%) were bilinguals with various L1s (Farsi, Spanish, Chinese, Tagalog, Arabic, others). When compared to the 179 monolingual AD patients, those who were bilingual had significant delays in ages of onset and presentation of approximately 4 years (p = 0.003). These delays persisted despite bilinguals having worse MMSE scores on presentation. There were no significant group differences on other variables except for worse naming in English among bilinguals versus monolinguals. Caregiver/informants reported that 66 (89.2%) of the 74 bilingual AD patients had gradually regressed to the predominant use of their L1. Conclusions: In line with published reports worldwide, we found that bilingualism delays the expression of Alzheimer's clinical syndrome. We also found frequent reversion to the first learned language. These findings suggest that, among bilinguals, the availability of an L1 "back-up" either facilitates compensation or masks emergence of the early symptoms of dementia. Keywords: Age of onset, Language, Dementia, Bilingualism, Alzheimer's disease