V.A. Greater Los Angeles Healthcare System, Los Angeles, California, USA,
Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA,
Dement Geriatr Cogn Disord. 2019;48(5-6):281-289. doi: 10.1159/000505872. Epub 2020 Feb 11.
To evaluate the effects of bilingualism on the emergence of Alzheimer's clinical syndrome.
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.
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.
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.
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.
评估双语对阿尔茨海默病临床综合征出现的影响。
研究提出了通过管理和控制两种语言来增加认知和神经储备，从而延迟痴呆的表现。
在一个有大量移民人口的诊所中，我们确定了 253 名有中间或高证据表明存在阿尔茨海默病病理生理过程的可能阿尔茨海默病（AD）患者。对这些患者进行了人口统计学变量、母语（非英语）、发病和发病年龄、简易精神状态检查（MMSE）、数字跨度、单词流畅性、命名和记忆的回顾。
在这些患者中，有 74 名（29.2%）是双语者，母语为多种语言（波斯语、西班牙语、中文、塔加洛语、阿拉伯语、其他语言）。与 179 名单语 AD 患者相比，双语者的发病和发病年龄有显著延迟，大约 4 年（p = 0.003）。尽管双语者在发病时的 MMSE 评分更差，但这些延迟仍然存在。除了双语者的英语命名能力较差外，其他变量在两组之间没有显著差异。护理人员/知情人报告说，74 名双语 AD 患者中有 66 名（89.2%）逐渐回归到主要使用其母语。
与全球发表的报告一致，我们发现双语延迟了阿尔茨海默病临床综合征的表现。我们还发现，双语者经常恢复到第一语言。这些发现表明，在双语者中，母语的可用性要么促进了补偿，要么掩盖了痴呆早期症状的出现。
