Bilingualism for delaying the onset of Alzheimer’s disease: a systematic review and meta-analysis

Paulavicius, A; Mizzaci, Carolina Christianini; Tavares, Daniela Regina Brandão; Rocha, Aline Pereira da; Civile, Vinicius Tassoni; Schultz, Rodrigo Rizek; Pinto, Ana Carolina Pereira Nunes; Trevisani, Virgínia Fernandes Moça

doi:10.1007/s41999-020-00326-x

Cited by 19 publications

(22 citation statements)

References 27 publications

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“…Finally, bilingualism, or the ability to speak two or more languages, is a skill that requires cognitive effort and interaction by many individuals on a regular basis. Similar to other mentally stimulating activities, bilingualism is linked to a delay in the onset and diagnosis of dementia (Bialystok et al, 2007), a robust finding that has been replicated multiple times (Anderson et al, 2020;Brini et al, 2020;Paulavicius et al, 2020). Although research on the relationship between the two is nascent, substantial and significant evidence has been found for bilingualism as a crucial factor that increases cognitive reserve.…”

Section: Cognitive Reservementioning

confidence: 95%

“…Moreover, a more recent meta-analyses including eight studies found that on average, bilinguals exhibit AD symptoms 4.1 years and are diagnosed with AD 2.0 years later than monolinguals (Paulavicius et al, 2020). Another confirmed a 4.7-year delay in AD onset and a 3.3-year delay in the diagnosis of dementia, but no delay in the diagnosis of mild cognitive impairment (Brini et al, 2020).…”

Section: Bilingual Cognitive Reservementioning

confidence: 96%

“…Clearly, this research domain would benefit from studies specifically looking at the moderating effects of bilingualism on the aging brain. Excellent literature reviews of the effects of bilingualism and cognitive reserve are provided by Calvo et al (2016) and Klimova et al (2017), and recent meta-analyses by Mukadam et al (2017b); Anderson et al (2020); Brini et al (2020); Paulavicius et al (2020). None of these articles make reference to the plausibility of bilingualism as a moderator, or equally if not more important, as a mediator, to which we now turn.…”

Section: Moderatormentioning

confidence: 99%

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Moderation-Mediation Effects in Bilingualism and Cognitive Reserve

2020

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We first provide a critical review of the existing findings on bilingualism as a contributor to cognitive reserve from moderator-mediator warranting cause-effect research conclusions. We next address the question of direct or indirect effects between bilingualism and neurocognitive protective factors influencing the associated age-related mental deficits. The existing findings support bilingualism as a predictor and as a moderator. Third, we propose cognitive reserve models of bilingualism describing analytical approaches that allow testing of these models and hypotheses related to path strength and causal relationships between predictors, moderators, and mediators. Lastly and most importantly, we suggest using large datasets available via open repositories. This can aid in the testing of theoretical models, clarifying the roles of moderators and mediators, and assessing the research viability of multi-causal paths that can influence cognitive reserve. Creating collaborative datasets to test these models would greatly advance our field and identify critical variables in the study of the bilingual aging brain.

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Section: Cognitive Reservementioning

confidence: 95%

Section: Bilingual Cognitive Reservementioning

confidence: 96%

Section: Moderatormentioning

confidence: 99%

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Moderation-Mediation Effects in Bilingualism and Cognitive Reserve

2020

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“…Having explored the contextual evidence supporting bilingualism as a cognitive reserve factor, we now evaluate the systematic review from Paulavicius et al (23) exploring bilingualism and age of onset of dementia and the specific epidemiological studies exploring this relationship.…”

Section: Does Bilingualism Delay the Onset Of Dementia? Key Findings From A Systematic Reviewmentioning

confidence: 99%

“…A recent metanalysis by Paulavicius et al (23) revealed that studies that explored the relationship between bilingualism and age of onset of dementia revealed an average of 4.5 years in the delay of presentation of dementia amongst bilinguals. In this perspective piece, we critically review bilingualism as a cognitive reserve factor and examine the key studies of bilingualism explored in both high income countries (HICs) and LMICs.…”

Section: Introductionmentioning

confidence: 99%

Bilingualism: A Global Public Health Strategy for Healthy Cognitive Aging

Mendis

Raymont²,

Tabet

2021

Front. Neurol.

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Dementia is a global public health priority which cost global societies $818 billion in 2015 and is disproportionately impacting low and middle-income countries (LMICs). With limited availability of disease modifying drugs to treat Alzheimer's disease (AD), researchers have increasingly focused on preventative strategies which may promote healthy cognitive aging and mitigate the risk of cognitive impairment in aging. Lifelong bilingualism has been presented as both a highly debated and promising cognitive reserve factor which has been associated with better cognitive outcomes in aging. A recent metanalysis has suggested that bilingual individuals present on average 4.05 years later with the clinical features of AD than monolinguals. Bilinguals are also diagnosed with AD ~2.0 years later than monolingual counterparts. In this perspective piece we critically evaluate the findings of this metanalysis and consider the specific implications of these findings to LMICs. Furthermore, we appraise the major epidemiological studies conducted globally on bilingualism and the onset of dementia. We consider how both impactful and robust studies of bilingualism and cognition in older age may be conducted in LMICs. Given the limited expenditure and resources available in LMICs and minimal successes of clinical trials of disease modifying drugs we propose that bilingualism should be positioned as an important and specific public health strategy for maintaining healthy cognitive aging in LMICs. Finally, we reflect upon the scope of implementing bilingualism within the education systems of LMICs and the promotion of bilingualism as a healthy cognitive aging initiative within government policy.

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