Bilingualism, assessment language, and the Montreal Cognitive Assessment in Mexican Americans

Abstract

Background/Objectives Assessment of cognition in linguistically diverse aging populations is a growing need. Bilingualism may complicate cognitive measurement precision, and bilingualism may vary across Hispanic/Latinx sub‐populations. We examined the association among bilingualism, assessment language, and cognitive screening performance in a primarily non‐immigrant Mexican American community. Design Prospective, community‐based cohort study: The Brain Attack Surveillance in Corpus Christi (BASIC)‐Cognitive study. Setting Nueces County, Texas. Participants Community‐dwelling Mexican Americans age 65+, recruited door‐to‐door using a two‐stage area probability sampling procedure. Measurements Montreal Cognitive Assessment (MoCA); self‐reported bilingualism scale. Participants were classified as monolingual, Spanish dominant bilingual, English dominant bilingual, or balanced bilingual based upon bilingualism scale responses. Linear regressions examined relationships among bilingualism, demographics, cognitive assessment language, and MoCA scores. Results The analytic sample included 547 Mexican American participants (60% female). Fifty‐eight percent were classified as balanced bilingual, the majority (88.6%) of whom selected assessment in English. Balanced bilinguals that completed the MoCA in English performed better than balanced bilinguals that completed the MoCA in Spanish (b = −4.0, p < 0.05). Among balanced bilinguals that took the MoCA in Spanish, education outside of the United States was associated with better performance (b = 4.4, p < 0.001). Adjusting for demographics and education, we found no association between the degree of bilingualism and MoCA performance (p's > 0.10). Conclusion Bilingualism is important to consider in cognitive aging studies in linguistically diverse communities. Future research should examine whether cognitive test language selection affects cognitive measurement precision in balanced bilinguals.

Stroke Outcomes Among English- and Spanish-Speaking Mexican American Patients

“…Cognitive screening tools may be biased or nonequivalent across language preference or degree of bilingualism. 6,7 Reports suggest that bilingualism leads to better poststroke outcome. 8 It is possible that there is increased resilience or cognitive reserve in these individuals, or that any communication in English, however limited, reduces possible negative effects of language discordance between the patient and provider on stroke outcomes.…”

Differential Impact of Stroke on Cognitive Impairment in Mexican Americans and Non-Hispanic White Americans

“…33,46,47 This is an area of ongoing research within the BASIC-Cognitive project. 48,49 Additionally, we relied on self-report for ascertainment of medical history variables and stroke history, which may have been impacted by recall bias, though self-reported stroke has been determined to be a valid measure of clinical stroke history. 28 As we did not have clinical records, we were unable to assess stroke severity, stroke recurrence, or stroke mechanism, which have been shown to predict poststroke cognitive outcomes.…”

Bilingual neurocognitive resiliency, vulnerability, and Alzheimer's disease biomarker correlates in Latino older adults enrolled in the Health and Aging Brain Study ‐ Health Disparities (HABS‐HD)

“… 38 As such, our understanding of the basic cognitive profiles of monolingual and bilingual Latino older adults with and without cognitive impairment is severely lacking. 7 , 12 Mixed findings exist with respect to potential differences in performance on cognitive screening instruments in aging bilinguals 39 , 40 ; however, a greater degree of bilingualism has been associated with higher scores on a subset of neuropsychological measures that assess attention/processing speed and executive functions. 41 These findings indicate that further research characterizing the effects of bilingualism on neuropsychological measures is warranted.…”