Bilingualism provides a neural reserve for aging populations

Language Learning for People Living with Dementia and Their Caregivers: Feasibility and the Quality of Experience

BACKGROUND

A body of research from around the world has reported positive effects of bilingualism on cognitive ageing and dementia. However, little is known about whether foreign language learning could be applied as an intervention for people already living with dementia. Yet, before it is possible to determine the efficacy of language courses as an intervention for people living with dementia (PLWD), it is necessary to establish whether such an intervention is feasible. Our study explored this possibility.

METHODS

We conducted an exploratory study to examine the feasibility and tolerability of 2-week Italian beginner courses for PLWD in early stages and their family carers in two Scottish Dementia Resource Centres (DRCs). The courses were delivered by trained tutors from Lingo Flamingo, a social enterprise specialising in language teaching for older learners and learners with dementia. Twelve PLWD and seven carers participated in the study. Focus groups preceded and followed the courses. Additional post-course open interviews with the DRC managers were conducted, with a follow-up via telephone approximately one year later.

RESULTS

Qualitative content analysis resulted in 12 themes, 5 reflected in the interview schedule and 7 arising from the focus groups and interviews. Overall, the courses were perceived positively by PLWD, carers, and DRC managers, although a few logistically and linguistically challenging aspects were also mentioned. The courses were found to positively impact both the individual by increasing self-esteem and producing a sense of accomplishment as well as the group by creating a sense of community. Notably, no adverse effects (in particular no confusion or frustration) were reported.

CONCLUSION

The positive outcomes of our study open a novel avenue for future research to explore foreign language training in dementia as an intervention and its implications.

Does Diglossia Impact Brain Structure? Data from Swiss German Early Diglossic Speakers

(1) Background: Bilingualism has been reported to shape the brain by inducing cortical changes in cortical and subcortical language and executive networks. Similar yet different to bilingualism, diglossia is common in Switzerland, where the German-speaking population switches between an everyday spoken Swiss German (CH-GER) dialect and the standard German (stGER) used for reading and writing. However, no data are available for diglossia, defined as the use of different varieties or dialects of the same language, regarding brain structure. The aim of our study is to investigate if the presence of this type of diglossia has an impact on the brain structure, similar to the effects seen in bilingualism. (2) Methods: T1-weighted anatomical MRI scans of participants were used to compare the grey matter density and grey matter volume of 22 early diglossic CH-GER-speaking and 20 non-diglossic French-speaking right-handed university students, matched for age, linguistics and academic background. The images were processed with Statistical Parametric Mapping SPM12 and analyzed via voxel- and surface-based morphometry. (3) Results: A Bayesian ANCOVA on the whole brain revealed no differences between the groups. Also, for the five regions of interest (i.e., planum temporale, caudate nucleus, ACC, DLPFC and left interior parietal lobule), no differences in the cortical volume or thickness were found using the same statistical approach. (4) Conclusion: The results of this study may suggest that early diglossia does not shape the brain structure in the same manner as bilingualism.

Auditory discrimination in aging bilinguals vs. monolinguals with and without hearing loss

Demands for effective assessments of speech perception specific to the aging brain are increasing, as the impacts of hearing loss on an individual's functional health, socialization, and cognition have become more widely recognized. Understanding the mechanisms behind the optimal function of the aging brain in relation to speech and language is challenging, especially in the bilingual population where the language learning and language interference processes could be mistaken for perceptual difficulty. Age-related presbycusis is unavoidable, and the contributions of this sensorineural hearing loss (SNHL) process on impaired speech recognition are not completely understood. This lack of understanding of the effects of aging and bilingual language competency on speech perception can act as a barrier to successful auditory rehabilitation. The present study investigated the effects of aging on vowel sound discrimination in adult listeners (age 50+) with the following characteristics: American English (AE) monolinguals with normal hearing, simultaneous or early sequential Spanish-English (SE) bilinguals with normal hearing, and AE monolinguals with SNHL (AE-SNHL). The goal was to identify the differences in vowel sound discrimination performance between the monolingual and bilingual aging populations to guide future language assessments and intervention processes. English vowel discrimination was assessed using an AXB discrimination task in quiet and using the Quick Speech in Noise (QuickSIN) test. SE bilinguals were outperformed by AE and AE-SNHL monolinguals, suggesting SE bilinguals primarily use their L1 acoustic properties to discriminate speech segments. No significant difference was found in QuickSIN performance between the bilingual and the monolingual groups, but there was a significant difference between AE and AE-SNHL. In conclusion, vowel discrimination was affected by interference with the native language, while performance in the noise condition was affected by hearing loss. The results of this study contribute to our understanding of the age-related speech processing deficits from three different aging groups regarding the cognitive control system.

The Effect of Phonetic Similarity on Domain-General Executive Control in Color-Shape Task: Evidence from Cantonese-Mandarin and Beijing-Dialect-Mandarin Bidialectals

The present study was carried out to investigate whether bidialectals have a similar advantage in domain-general executive function as bilinguals and if so whether the phonetic similarity between two different dialects can modulate the executive function performance in the conflicting-switching task. The results showed that the latencies for switching trials in mixed block (SMs) were longest, non-switching trials in mixed block (NMs) were medium, and non-switching trials in pure block (NPs) were the shortest in the conflict-switching task in all three groups of participants. Importantly, the difference between NPs and NMs varied as a function of phonetic similarity between two dialects with Cantonese-Mandarin bidialectal speakers being the minimum, Beijing-dialect-Mandarin bidialectals medium, and Mandarin native speakers maximum. These results provide strong evidence that there is an advantage in balanced bidialectals's executive function which is modulated by the phonetic similarity between two dialects suggesting that phonetic similarity plays an important role in domain-general executive function.

Is there a cognitive advantage in inhibition and switching for bilingual children? A systematic review

Several studies have pointed to beneficial effects of bilingualism on executive functioning. However, observations of these beneficial effects have at times proven difficult to reproduce. Moreover, findings of studies on cognitive effects of bilingualism have been contested altogether. These contradictory outcomes leave the research field of bilingualism at unease. In the present review article, we aim to give a systematic overview of previous research on bilingual advantages in inhibition and switching in children up to the age of 12. Particular attention is paid to the experimental tasks that have been applied and the persistence of possible effects throughout critical and post-critical periods for cognitive development in children. In doing so, the review gives an insight in both the validity and robustness of possible domain-general cognitive effects of bilingualism in children. Terminological issues are also discussed.

Linking early-life bilingualism and cognitive advantage in older adulthood

Previous studies have identified bilingualism as a protective factor against dementia. Here we aimed to test whether being bilingual at different life stages impacts cognition and brain structure in older adulthood. We included 746 participants from the DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE). Assessment of bilingualism at 3 life stages (early: 13-30, middle: 30-65 and late: over 65 years old) was determined with the Lifetime of Experiences Questionnaire. Individuals reporting bilingualism (i.e., daily use of L2) in the early life stage outperformed monolinguals on learning & memory, working-memory, executive functions and language. Bilingualism in middle life stage showed a significant advantage on learning & memory, while no effect of bilingualism in old life stage was identified. Brain gray matter volume was not associated with L2 use and did not differ between groups. However, stronger correlations between brain gray matter volume in selected brain regions and cognitive performance were found in bilingual participants in the early and middle life stages. Our results indicate that bilingualism in early life might provide a long-lasting protective effect on cognition and shape the brain to sustain cognitive performance in older adulthood.

Resting-state functional connectivity in lifelong musicians

Background

It has been postulated that musicianship can lead to enhanced brain and cognitive reserve, but the neural mechanisms of this effect have been poorly understood. Lifelong professional musicianship in conjunction with novel brain imaging techniques offers a unique opportunity to examine brain network differences between musicians and matched controls.

Objective

In this study we aim to investigate how resting-state functional networks (FNs) manifest in lifelong active musicians. We will evaluate the FNs of lifelong musicians and matched healthy controls using resting-state functional magnetic resonance imaging.

Methods

We derive FNs using the data-driven independent component analysis approach and analyze the functional network connectivity (FNC) between the default mode (DMN), sensory-motor (SMN), visual (VSN), and auditory (AUN) networks. We examine whether the linear regressions between FNC and age are different between the musicians and the control group.

Results

The age trajectory of average FNC across all six pairs of FNs shows significant differences between musicians and controls. Musicians show an increase in average FNC with age while controls show a decrease (P = 0.013). When we evaluated each pair of FN, we note that in musicians FNC values increased with age in DMN-AUN, DMN-VSN, and SMN-VSN and in controls FNC values decreased with age in DMN-AUN, DMN-SMN, AUN-SMN, and SMN-VSN.

Conclusion

This result provides early evidence that lifelong musicianship may contribute to enhanced brain and cognitive reserve. Results of this study are preliminary and need to be replicated with a larger number of participants.

Gray Matter Volume as Evidence for Cognitive Reserve in Bilinguals With Mild Cognitive Impairment

BACKGROUND

Compared with monolinguals, bilinguals have a later onset of mild cognitive impairment (MCI) and Alzheimer disease symptoms and greater neuropathology at similar cognitive and clinical levels. The present study follows a previous report showing the faster conversion from MCI to Alzheimer disease for bilingual patients than comparable monolinguals, as predicted by a cognitive reserve (CR).

PURPOSE

Identify whether the increased CR found for bilinguals in the previous study was accompanied by greater gray matter (GM) atrophy than was present for the monolinguals.

METHODS

A novel deep-learning technique based on convolutional neural networks was used to enhance clinical scans into 1 mm MPRAGEs and analyze the GM volume at the time of MCI diagnosis in the earlier study.

PATIENTS

Twenty-four bilingual and 24 monolingual patients were diagnosed with MCI at a hospital memory clinic.

RESULTS

Bilingual patients had more GM loss than monolingual patients in areas related to language processing, attention, decision-making, motor function, and episodic memory retrieval. Bilingualism and age were the strongest predictors of atrophy after other variables such as immigration and education were included in a multivariate model.

DISCUSSION

CR from bilingualism is evident in the initial stages of neurodegeneration after MCI has been diagnosed.

Does Language Distance Modulate the Contribution of Bilingualism to Cognitive Reserve in Seniors? A Systematic Review

We report a systematic review and exploratory meta-regression investigating the hypothesis that the effects of bilingualism on cognitive reserve are modulated by the distance between the pair of languages a bilingual uses. An inclusive multiple database search was performed in order to identify all relevant published research conducted in bilingual seniors. A combination of qualitative and quantitative synthesis methods were used in order to investigate our research questions. Results suggest that healthy bilingual seniors speaking more distant language pairs show improved monitoring performance on cognitive tasks. Evidence regarding a modulatory influence of language distance (LD) on the age of dementia diagnosis was inconclusive due to the small number of published studies meeting our inclusion criteria. We recommend more detailed reporting of individual differences in bilingual experience to assess the impact of LD and other variables on typical cognitive aging and the development of dementia. Linguistic differences in samples should also be considered as a constraint on bilingual advantages in future studies. Preregistration: PROSPERO CRD42021238705; OSF DOI 10.17605/OSF.IO/VPRBU.

Intervention and Prevention of Dementia in the Greater Bay Area (GBA) of China

Reserve and resilience are recognized as essential for effective intervention and prevention of dementia. However, it is not known if these factors also protect against risk for dementia in the Greater Bay Area (GBA) of Mainland China. Studies of risk factors across regions of China provide an evidence base for future research in the GBA. However, population-based studies are rare and do not account for the cultural differences in levels of education, income, literacy and modifiable lifestyle factors. Critically, extant studies do not allow for differences in languages spoken across the region, which will bias results and potentially minimize true prevalence. Based on the conclusions reported in this Special Collection, research in the GBA should focus on resilience and reserve using preserved native language communication skills.

Can Speaking More Than One Language Help Prevent Alzheimer's Disease?

Alzheimer's disease (AD) is an age-related neurocognitive disorder that is epidemic in the elderly population. Currently, there are limited pharmacological interventions, and this has heightened the urgency to identify potential preventable or modifiable risk factors that promote resilience to the neuropathological effects of AD. The regular use of two or more languages is one such factor that may increases cognitive reserve through the long-standing executive control involved in managing multiple languages in the brain. There is also evidence that bilingualism is associated with increased brain reserve or maintenance, particularly in frontal-executive structures and networks. This review examines the current, sometimes conflicting literature on bi/multilingualism and AD. These studies have confounding variations in the assessment of age of second language onset, language proficiency, language usage, and whether determining incidence of AD or age of symptom onset. Despite these limitations, most publications support the presence of increased frontal-executive reserve that compensates for the development of AD neuropathology and, thereby, delays the emergence of clinical symptoms of dementia by about 4-5 years. Although regularly speaking more than one language does not protect against AD neuropathology, the delay in its clinical expression has a potentially significant impact on the lifelong morbidity from this age-related disease. Learning other languages may be an important modifiable factor for delaying the clinical expression of AD in later life.

Bilingualism can cause enhanced monitoring and occasional delayed responses in a flanker task

Complex cognitive tasks require different stages of processing (i.e. conflict monitoring, attentional resource allocation and stimulus categorisation). Performance differences between bilinguals and monolinguals on conflict tasks can be affected by the balance of these sub-processes. The current study investigated the effect of bilingualism on these sub-processes during a conflict task with medium monitoring demand. Behavioural responses and evoked potentials from bilinguals and monolinguals were examined during a flanker task with 25% incongruent trials. Behavioural differences were analysed by means of averaged response times and exponentially modified Gaussian analyses of response time distributions. For evoked potentials, the study focussed on N2 (reflecting conflict monitoring) and P3 responses (reflecting allocation of attentional resources for cognitive control). Bilinguals had significantly longer response distribution tails compared to monolinguals. Bilinguals were shown to have a more pronounced N2 and smaller P3 compared to monolinguals, independent of condition, suggesting a different balance of sub-processes for the two groups. This suggests that bilinguals were engaged more strongly in monitoring processes, leading to the allocation of fewer attentional resources during stimulus categorisation. Additionally, the P3 amplitudes were negatively related with the length of response distribution tails for bilinguals. These results are consistent with enhanced conflict monitoring in bilinguals that led to reduced engagement of attentional resources for stimulus categorisation. This enhanced conflict monitoring could lead to occasional extremely slow responses. Thus, the bilingual experience appears to impact the balance of cognitive control processes during conflict tasks, which might only be reflected in a minority of responses.

French Phonological Component Analysis and aphasia recovery: A bilingual perspective on behavioral and structural data

Studies show bilingualism entails an advantage in cognitive control tasks. There is evidence of a bilingual advantage in the context of aphasia, resulting in better cognitive outcomes and recovery in bilingual persons with aphasia compared to monolingual peers. This bilingual advantage also results in structural changes in the right hemisphere gray matter. Very few studies have examined the so-called bilingual advantage by reference to specific anomia therapy efficacy. This study aims to compare the effect of French-Phonological Component Analysis (Fr-PCA) in monolinguals and bilingual persons with aphasia, both at the linguistic and cognitive control level, and to examine the structural impact of left hemisphere lesion location and right hemisphere structural data. Eight participants with chronic aphasia received Fr-PCA for a total of 15 h over 5 weeks. The results showed improved accuracy for treated words and generalization to untreated items and discourse in both groups, and improved Flanker task performance for some participants. Bilingual participants improved more than monolinguals for picture-naming tasks and narrative discourse. Damage to the left postcentral gyrus and the middle frontal gyrus was associated with less therapy-induced improvement. Additionally, left hemisphere damage to the inferior parietal gyrus and postcentral gyrus was associated with reduced cognitive control pre-therapy. Undamaged right hemisphere cortical thicknesses were significantly different between groups; the inferior frontal gyrus and the middle frontal gyrus were greater for the bilingual participants and correlated with cognitive control skills. These results suggest a bilingual advantage in anomia recovery following Fr-PCA, potentially resulting from enhanced cognitive control abilities that could be supported by right hemisphere neural reserve.

Multifactorial approaches to study bilingualism in the aging population: Past, present, future

A better understanding and more reliable classification of bilinguals has been progressively achieved through the fine-tuning methodology and simultaneously optimizing the measurement tools. However, the current understanding is far from generalization to a larger population varying in different measures of bilingualism-L2 Age of acquisition (L2 AOA), L2 usage and exposure, and L2 proficiency. More recent studies have highlighted the importance of modeling bilingualism as a continuous variable. An in-depth look at the role of bilingualism, comparing groups, may be considered a reductionist approach, i.e., grouping based on one measure of bilingualism (e.g., L2 AOA) may not account for variability in other measures of bilingualism (L2 exposure, L2 use or L2 proficiency, amongst others) within and between groups. Similarly, a multifactorial dimension is associated with cognitive performance, where not all domains of cognition and subcomponents are equally influenced by bilingualism. In addition, socio-cultural and demographical factors may add another dimension to the impact of bilingualism on cognitive performance, especially in older adults. Nevertheless, not many studies have controlled or used the multiple socio-cultural and demographical factors as a covariate to understand the role of different aspects of bilingualism that may influence cognitive performance differently. Such an approach would fail to generalize the research findings to a larger group of bilinguals. In the present review paper, we illustrate that considering a multifactorial approach to different dimensions of bilingual study may lead to a better understanding of the role of bilingualism on cognitive performance. With the evolution of various fine-tuned methodological approaches, there is a greater need to study variability in bilingual profiles that can help generalize the result universally.

Cognitive Advantage of Bilingualism Over Monolingualism in Older Adults: A Meta-Analysis

OBJECTIVES

This study aimed to explore whether bilingual older adults had a cognitive advantage over their monolingual counterparts, and validate the influence of cognition-related (participants' cognitive condition, the cognitive domain assessed), and bilingualism-related factors (second language proficiency, frequency of use, acquisition time, and immigration status of participants)on the cognitive advantage of bilingualism.

METHODS

Through a systematic search of nine databases (Web of Science, PubMed, Elsevier Science Direct, Cochrane Library, Embase, PsycINFO, CNKI, VIP and Wanfang) from the inception to April 2021, observational studies with bilingual and monolingual older adults as participants and cognitive function scores as outcome measures were included. Two reviewers independently completed the selection and methodological quality assessment of studies using the JBI cross-sectional study quality evaluation tool and used a pre-designed table for data extraction and sorting.

RESULTS

Fourteen studies with 51 tasks were included, involving 3737 participants (bilingual group: 1695, monolingual group: 2042). The overall results of the meta-analysis showed that bilingualism had a small cognitive advantage over monolingualism in older adults [SMD=0.23, 95%CI (0.07, 0.38), P=0.004]. In addition, the subgroup analyses indicated that factors such as participants' cognitive condition, the cognitive domain assessed, second language proficiency, acquisition time, and immigration status of participants impacted the cognitive advantage of bilingualism in older adults.

CONCLUSION

Bilingualism had a mild cognitive advantage over monolingualism in older adults, which was more prominent in older adults with mild cognitive impairment than in cognitively healthy ones, more evident in global cognitive function and inhibitory control than in other individual cognitive domains, and might be influenced by the proficiency and acquisition time of second language as well as the immigration status of older adults.

Bilinguals' speech perception in noise: Perceptual and neural associations

The current study characterized subcortical speech sound processing among monolinguals and bilinguals in quiet and challenging listening conditions and examined the relation between subcortical neural processing and perceptual performance. A total of 59 normal-hearing adults, ages 19–35 years, participated in the study: 29 native Hebrew-speaking monolinguals and 30 Arabic-Hebrew-speaking bilinguals. Auditory brainstem responses to speech sounds were collected in a quiet condition and with background noise. The perception of words and sentences in quiet and background noise conditions was also examined to assess perceptual performance and to evaluate the perceptual-physiological relationship. Perceptual performance was tested among bilinguals in both languages (first language (L1-Arabic) and second language (L2-Hebrew)). The outcomes were similar between monolingual and bilingual groups in quiet. Noise, as expected, resulted in deterioration in perceptual and neural responses, which was reflected in lower accuracy in perceptual tasks compared to quiet, and in more prolonged latencies and diminished neural responses. However, a mixed picture was observed among bilinguals in perceptual and physiological outcomes in noise. In the perceptual measures, bilinguals were significantly less accurate than their monolingual counterparts. However, in neural responses, bilinguals demonstrated earlier peak latencies compared to monolinguals. Our results also showed that perceptual performance in noise was related to subcortical resilience to the disruption caused by background noise. Specifically, in noise, increased brainstem resistance (i.e., fewer changes in the fundamental frequency (F0) representations or fewer shifts in the neural timing) was related to better speech perception among bilinguals. Better perception in L1 in noise was correlated with fewer changes in F0 representations, and more accurate perception in L2 was related to minor shifts in auditory neural timing. This study delves into the importance of using neural brainstem responses to speech sounds to differentiate individuals with different language histories and to explain inter-subject variability in bilinguals’ perceptual abilities in daily life situations.

Foreign Language Learning in Older Adults: Anatomical and Cognitive Markers of Vocabulary Learning Success

In recent years, foreign language learning (FLL) has been proposed as a possible cognitive intervention for older adults. However, the brain network and cognitive functions underlying FLL has remained largely unconfirmed in older adults. In particular, older and younger adults have markedly different cognitive profile—while older adults tend to exhibit decline in most cognitive domains, their semantic memory usually remains intact. As such, older adults may engage the semantic functions to a larger extent than the other cognitive functions traditionally considered the most important (e.g., working memory capacity and phonological awareness). Using anatomical measurements and a cognitive test battery, the present study examined this hypothesis in twenty cognitively normal older adults (58–69 years old), who participated in a two-month Italian learning programme. Results showed that the immediate learning success and long-term retention of Italian vocabularies were most consistently predicted by the anatomical measures of the left pars orbitalis and left caudal middle frontal cortex, which are implicated in semantic and episodic memory functions. Convergent evidence was also found based on the pattern of cognitive associations. Our results are consistent with a prominent role of semantic and episodic memory functions in vocabulary learning in older learners.

Bilingualism and Aging: Implications for (Delaying) Neurocognitive Decline

As a result of advances in healthcare, the worldwide average life expectancy is steadily increasing. However, this positive trend has societal and individual costs, not least because greater life expectancy is linked to higher incidence of age-related diseases, such as dementia. Over the past few decades, research has isolated various protective "healthy lifestyle" factors argued to contribute positively to cognitive aging, e.g., healthy diet, physical exercise and occupational attainment. The present article critically reviews neuroscientific evidence for another such factor, i.e., speaking multiple languages. Moreover, with multiple societal stakeholders in mind, we contextualize and stress the importance of the research program that seeks to uncover and understand potential connections between bilingual language experience and cognitive aging trajectories, inclusive of the socio-economic impact it can have. If on the right track, this is an important line of research because bilingualism has the potential to cross-over socio-economic divides to a degree other healthy lifestyle factors currently do not and likely cannot.

The neuroanatomical consequences and pathological implications of bilingualism

In recent years, there has been a rise in the number of people who are able to speak two or more languages. This has been paralleled by an increase in research related to bilingualism. Despite this, much of the neuroanatomical consequences and pathological implications of bilingualism are still subject to discussion. This review aims to evaluate the neuroanatomical structures related to language and to the acquisition of a second language as well as exploring how learning a second language can alter one's susceptibility to and the progression of certain cerebral pathologies. A literature search was conducted on the Medline, Embase, and Web of Science databases. A total of 137 articles regarding the neuroanatomical or pathological implications of bilingualism were included for review. Following analysis of the included papers, this review finds that bilingualism induces significant gray and white matter cerebral changes, particularly in the frontal lobes, anterior cingulate cortex, left inferior parietal lobule and subcortical areas, and that native language and acquired language largely recruit the same neuroanatomical structures with however, subtle functional and anatomical differences dependent on proficiency and age of language acquisition. There is adequate evidence to suggest that bilingualism offsets the symptoms and diagnosis of dementia, and that it is protective against both pathological and age-related cognitive decline. While many of the neuroanatomical changes are known, more remains to be elucidated and the relationship between bilingualism and other neurological pathologies remains unclear.

Lifelong bilingualism and mechanisms of neuroprotection in Alzheimer dementia

Lifelong bilingualism is associated with delayed dementia onset, suggesting a protective effect on the brain. Here, we aim to study the effects of lifelong bilingualism as a dichotomous and continuous phenomenon, on brain metabolism and connectivity in individuals with Alzheimer's dementia. Ninety-eight patients with Alzheimer's dementia (56 monolinguals; 42 bilinguals) from three centers entered the study. All underwent an [18F]-fluorodeoxyglucose positron emission tomography (PET) imaging session. A language background questionnaire measured the level of language use for conversation and reading. Severity of brain hypometabolism and strength of connectivity of the major neurocognitive networks was compared across monolingual and bilingual individuals, and tested against the frequency of second language life-long usage. Age, years of education, and MMSE score were included in all above mentioned analyses as nuisance covariates. Cerebral hypometabolism was more severe in bilingual compared to monolingual patients; severity of hypometabolism positively correlated with the degree of second language use. The metabolic connectivity analyses showed increased connectivity in the executive, language, and anterior default mode networks in bilingual compared to monolingual patients. The change in neuronal connectivity was stronger in subjects with higher second language use. All effects were most pronounced in the left cerebral hemisphere. The neuroprotective effects of lifelong bilingualism act both against neurodegenerative processes and through the modulation of brain networks connectivity. These findings highlight the relevance of lifelong bilingualism in brain reserve and compensation, supporting bilingual education and social interventions aimed at usage, and maintenance of two or more languages, including dialects, especially crucial in the elderly people.

How does bilingualism modify cognitive function? Attention to the mechanism

It has been claimed that bilingual experience leads to an enhancement of cognitive control across the lifespan, a claim that has been investigated by comparing monolingual and bilingual groups performing standard executive function (EF) tasks. The results of these studies have been inconsistent, however, leading to controversy over the essential assumptions underlying the research program, namely, whether bilingualism produces cognitive change. We argue that the source of the inconsistency is not in the evidence but rather in the framework that has typically been used to motivate the research and interpret the results. We examine the componential view of EF with its central role for inhibition and argue that it provides a poor fit to both bilingual experience and the results of these studies. As an alternative, we propose a more holistic account based on attentional control that overrides the processes in the componential model of EF and applies to a wider range of tasks. The key element in our account is that behavioral differences between monolingual and bilingual individuals reflect differences in the efficiency and deployment of attentional control between the two language groups. In support of this point we show how attentional control provides a more satisfactory account for a range of findings that cannot reasonably be attributed to inhibition. We also suggest that group differences will emerge only when the attentional demands of a task exceed the control abilities of one of the groups, regardless of the EF components involved. We then review literature from across the lifespan to evaluate the extent to which this account is consistent with existing evidence, and conclude with some suggestions on how the field may be advanced by new lines of empirical enquiry.

An Overview of Cognitive Reserve in Aging Based on Keyword Network Analysis

Many studies have reported that Cognitive reserve is a critical mechanism affecting cognitive statuses, such as dementia. The purposes of this study were to identify the knowledge structure and the research trend on cognitive reserve by conducting keyword analysis on research papers ranging from the earliest to the most recent studies done on the topic and to suggest directions for future research. The Web of Science (WOS) database was used to search for articles on cognitive reserve in aging from 2001 to 2020. NetMiner version 4 (cyram, KOREA), a social network analysis program, was used for keyword network analysis. Data analysis showed keywords that could be categorized as cognitive reserve related keywords (cognitive reserve related concepts, cognitive reserve related factor, cognitive reserve diagnosis and measurement, cognitive reserve outcomes) and cognitive reserve research keywords (research subject/disease, research method, intervention, research field). Through trend analysis, we found that various keywords appeared, indicating that the research has gradually developed conceptually and methodically. Based on these findings, future CR studies require the development of multimodal interface-based tools by applying modern digital technology that can be used to more accurately diagnose and monitor CR; remotely, in real time. In addition, to improve CR, it is suggested that the development of cognitive stimulation interventions utilizing VR which fuses AI based interaction technology with the subjects. Finally, CR could develop further through a cooperation of multidisciplinary professionals such as psychology, medicine and nursing.

Predicting multilingual effects on executive function and individual connectomes in children: An ABCD study

While there is a substantial amount of work studying multilingualism's effect on cognitive functions, little is known about how the multilingual experience modulates the brain as a whole. In this study, we analyzed data of over 1,000 children from the Adolescent Brain Cognitive Development (ABCD) Study to examine whether monolinguals and multilinguals differ in executive function, functional brain connectivity, and brain-behavior associations. We observed significantly better performance from multilingual children than monolinguals in working-memory tasks. In one finding, we were able to classify multilinguals from monolinguals using only their whole-brain functional connectome at rest and during an emotional n-back task. Compared to monolinguals, the multilingual group had different functional connectivity mainly in the occipital lobe and subcortical areas during the emotional n-back task and in the occipital lobe and prefrontal cortex at rest. In contrast, we did not find any differences in behavioral performance and functional connectivity when performing a stop-signal task. As a second finding, we investigated the degree to which behavior is reflected in the brain by implementing a connectome-based behavior prediction approach. The multilingual group showed a significant correlation between observed and connectome-predicted individual working-memory performance scores, while the monolingual group did not show any correlations. Overall, our observations suggest that multilingualism enhances executive function and reliably modulates the corresponding brain functional connectome, distinguishing multilinguals from monolinguals even at the developmental stage.

Determinants of bilingualism predict dynamic changes in resting state EEG oscillations

This study uses resting state EEG data from 103 bilinguals to understand how determinants of bilingualism may reshape the mind/brain. Participants completed the LSBQ, which quantifies language use and crucially the division of labor of dual-language use in diverse activities and settings over the lifespan. We hypothesized correlations between the degree of active bilingualism with power of neural oscillations in specific frequency bands. Moreover, we anticipated levels of mean coherence (connectivity between brain regions) to vary by degree of bilingual language experience. Results demonstrated effects of Age of L2/2L1 onset on high beta and gamma powers. Higher usage of the non-societal language at home and society modulated indices of functional connectivity in theta, alpha and gamma frequencies. Results add to the emerging literature on the neuromodulatory effects of bilingualism for rs-EEG, and are in line with claims that bilingualism effects are modulated by degree of engagement with dual-language experiential factors.

Does Second Language Learning Promote Neuroplasticity in Aging? A Systematic Review of Cognitive and Neuroimaging Studies

As the population ages, understanding how to maintain older adults' cognitive abilities is essential. Bilingualism has been linked to higher cognitive reserve, better performance in executive control, changes in brain structure and function relative to monolinguals, and delay in dementia onset. Learning a second language thus seems a promising avenue for cognitive enhancement in older adults. Our review aims to determine whether learning a foreign language in later life improves cognition and promotes neuroplasticity. We screened articles from the Pubmed, Scopus, and Science Direct databases to identify interventional studies using second language training in senior participants, including either cognition or neuroimaging as outcome measures. A total of nine articles were found, with only one neuroimaging study. Results from these studies are inconsistent, but tend to suggest that second language learning is associated with improvement in attentional switching, inhibition, working memory, and increased functional connectivity. We discuss the implications of these results, and suggest new directions and methodological recommendations for future research.

Moving From Bilingual Traits to States: Understanding Cognition and Language Processing Through Moment-to-Moment Variation

The study of how bilingualism is linked to cognitive processing, including executive functioning, has historically focused on comparing bilinguals to monolinguals across a range of tasks. These group comparisons presume to capture relatively stable cognitive traits and have revealed important insights about the architecture of the language processing system that could not have been gleaned from studying monolinguals alone. However, there are drawbacks to using a group-comparison, or Traits, approach. In this theoretical review, we outline some limitations of treating executive functions as stable traits and of treating bilinguals as a uniform group when compared to monolinguals. To build on what we have learned from group comparisons, we advocate for an emerging complementary approach to the question of cognition and bilingualism. Using an approach that compares bilinguals to themselves under different linguistic or cognitive contexts allows researchers to ask questions about how language and cognitive processes interact based on dynamically fluctuating cognitive and neural states. A States approach, which has already been used by bilingualism researchers, allows for cause-and-effect hypotheses and shifts our focus from questions of group differences to questions of how varied linguistic environments influence cognitive operations in the moment and how fluctuations in cognitive engagement impact language processing.

The protective impact of education on brain structure and function in Alzheimer's disease

BACKGROUND

The Cognitive Reserve (CR) theory posits that brains with higher reserve can cope with more cerebral damage to minimize clinical manifestations. The aim of this study was to examine the effect of education (CR proxy) on brain structure and function in Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) patients and in cognitively healthy elderly (HC) individuals.

METHODS

Fifty-seven AD patients, 57 aMCI patients and 48 HCs were included to investigate the relationships between education years and gray matter volume (GMV), regional homogeneity (ReHo) and functional connectivity (FC) in brain regions to show associations with both structure and function. Taking the severity of the disease into account, we further assessed the relationships in AD stratified analyses.

RESULTS

In AD group, the GMV of the dorsal anterior cingulate cortex (dACC) and ReHo in the left inferior temporal cortex (ITC) were inversely associated with education years, after adjustment for age, sex, Mini-Mental State Examination (MMSE), and total intracranial volume or head motion parameters. Seed-based FC analyses revealed that education years were negatively correlated with the FC between the left anterior ITC and left mid frontal cortex as well as right superior frontal cortex and right angular gyrus. Stratified analyses results indicated that this negative relation between education and GMV, ReHo, FC was mainly present in mild AD, which was attenuated in moderate AD and aMCI groups.

CONCLUSIONS

Our results support the CR theory, and suggest that CR may be protective against AD related brain pathology at the early stage of clinical dementia. These findings could provide the locus of CR-related functional brain mechanisms and a specific time-window for therapeutic interventions to help AD patients to cope better with the brain pathological damage by increasing CR.

The bilingual structural connectome: Dual-language experiential factors modulate distinct cerebral networks

Bilingualism is a natural laboratory for studying whether the brain's structural connectome is influenced by different aspects of language experience. However, evidence on how distinct components of bilingual experience may contribute to structural brain adaptations is mixed. The lack of consistency, however, may depend, at least in part, on methodological choices in data acquisition and processing. Herein, we adopted the Network Neuroscience framework to investigate how individual differences in second language (L2) exposure, proficiency, and age of acquisition (AoA) - measured as continuous between-subject variables - relate to whole-brain structural organization. We observed that L2 exposure modulated the connectivity of two networks of regions subserving language comprehension and production. L2 proficiency was associated with enhanced connectivity within a rostro-caudal network, which supports language selection and word learning. Moreover, L2 AoA and exposure affected inter-hemispheric communication between control-related regions. These findings expand mechanistic knowledge about particular environmental factors associated with specific variation in brain structure.

Evidence for cognitive and brain reserve supporting executive control of memory in lifelong bilinguals

Recent bilingualism research attempts to understand whether continually controlling multiple languages provides domain-general benefits to other aspects of cognition. Yet little attention has been given to whether this extends to resistance to proactive interference (PI), which involves the filtering of irrelevant memory traces in order to focus attention on relevant to-be-remembered information. The present study sought to determine whether bilingualism provides benefits to resistance to PI performance and brain structure in regions supporting executive control of memory. Eighty-two younger and older adult participants, half English monolinguals and half highly proficient Spanish-English bilinguals, completed directed forgetting and release from PI tasks and underwent an MRI scan that measured cortical volume, thickness, and white matter integrity. While behavioral performance between bilinguals and monolinguals did not differ, bilinguals displayed thinner cortex in brain regions related to resistance to PI, providing evidence for cognitive reserve, and showed positive relationships between white matter integrity and resistance to PI performance, indicative of brain reserve. This study is the first to demonstrate cognitive reserve and brain reserve in different brain structure indices within the same healthy participants and suggests that bilingualism supports important structural relationships between regions necessary for executive control of memory.

Bilingualism: A Global Public Health Strategy for Healthy Cognitive Aging

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.

Bilinguals who stutter: A cognitive perspective

PURPOSE

Brain differences, both in structure and executive functioning, have been found in both developmental stuttering and bilingualism. However, the etiology of stuttering remains unknown. The early suggestion that stuttering is a result of brain dysfunction has since received support from various behavioral and neuroimaging studies that have revealed functional and structural brain changes in monolinguals who stutter (MWS). In addition, MWS appear to show deficits in executive control. However, there is a lack of data on bilinguals who stutter (BWS). This literature review is intended to provide an overview of both stuttering and bilingualism as well as synthesize areas of overlap among both lines of research and highlight knowledge gaps in the current literature.

METHODS

A systematic literature review on both stuttering and bilingualism studies was conducted, searching for articles containing "stuttering" and/or "bilingualism" and either "brain", "executive functions", "executive control", "motor control", "cognitive reserve", or "brain reserve" in the PubMed database. Additional studies were found by examining the reference list of studies that met the inclusion criteria.

RESULTS

A total of 148 references that met the criteria for inclusion in this paper were used in the review. A comparison of the impact of stuttering or bilingualism on the brain are discussed.

CONCLUSION

Previous research examining a potential bilingual advantage for BWS is mixed. However, if such an advantage does exist, it appears to offset potential deficits in executive functioning that may be associated with stuttering.

Bilingualism and domain-general cognitive functions from a neural perspective: A systematic review

A large body of research has indicated that bilingualism - through continual practice in language control - may impact cognitive functions, as well as relevant aspects of brain function and structure. The present review aimed to bring together findings on the relationship between bilingualism and domain-general cognitive functions from a neural perspective. The final sample included 210 studies, covering findings regarding neural responses to bilingual language control and/or domain-general cognitive tasks, as well as findings regarding effects of bilingualism on non-task-related brain function and brain structure. The evidence indicates that a) bilingual language control likely entails neural mechanisms responsible for domain-general cognitive functions; b) bilingual experiences impact neural responses to domain-general cognitive functions; and c) bilingual experiences impact non-task-related brain function (both resting-state and metabolic function) as well as aspects of brain structure (both macrostructure and microstructure), each of which may in turn impact mental processes, including domain-general cognitive functions. Such functional and structural neuroplasticity associated with bilingualism may contribute to both cognitive and neural reserves, producing benefits across the lifespan.

Neural signatures of inhibitory control in intra-sentential code-switching: Evidence from fMRI

In this study we examined the neural control mechanisms that are at play when habitual code-switchers read code-switches embedded in a sentence context. The goal was also to understand if and to what extent the putative control network that is engaged during the comprehension of code-switched sentences is modulated by the linguistic regularity of those switches. Towards that goal, we tested two different types of code switches (switches at the noun-phrase boundary and switches at the verb-phrase boundary) that despite being both represented in naturalistic corpora of code switching, show different distributional properties. Results show that areas involved in general cognitive control (e.g., pre-SMA, anterior cingulate cortex) are recruited when processing code-switched sentences, relative to non-code-switched sentences. Additionally, significant activation in the cerebellum when processing sentences containing code-switches at the noun-phrase boundary suggests that habitual code-switchers might engage a wider control network to adapt inhibitory control processes according to task demands. Results are discussed in the context of the current literature on neural models of bilingual language control.

Bilingualism's Effects on Resting-State Functional Connectivity in Mild Cognitive Impairment

Background: Bilingualism is considered a cognitive reserve (CR) factor, due to the delay in the onset of dementia in bilinguals compared with monolinguals. Two neural mechanisms have been suggested to underlie CR: neural reserve and neural compensation. However, it is still unclear how bilingualism contributes to these mechanisms. Methods: In this study, we used cognitive tests, functional connectivity (FC), regional homogeneity, and fractional amplitude of low-frequency fluctuations (fALFF) measures to study resting-state brain patterns in a sample of bilingual and monolingual subjects with mild cognitive impairment. Results: We found no significant differences between the groups in age, sex, education, or cognitive level, but bilinguals showed higher FC than monolinguals between the posterior part of the superior temporal gyrus and the precuneus, positively correlated with Mini-Mental State Examination scores, and higher fALFF in the thalamus bilaterally. Conclusions: Our results suggest that bilingualism may act as a CR factor that protects against dementia through neural compensation.

Characterizing Bilingual Effects on Cognition: The Search for Meaningful Individual Differences

A debate over the past decade has focused on the so-called bilingual advantage-the idea that bilingual and multilingual individuals have enhanced domain-general executive functions, relative to monolinguals, due to competition-induced monitoring of both processing and representation from the task-irrelevant language(s). In this commentary, we consider a recent study by Pot, Keijzer, and de Bot (2018), which focused on the relationship between individual differences in language usage and performance on an executive function task among multilingual older adults. We discuss their approach and findings in light of a more general movement towards embracing complexity in this domain of research, including individuals' sociocultural context and position in the lifespan. The field increasingly considers interactions between bilingualism/multilingualism and cognition, employing measures of language use well beyond the early dichotomous perspectives on language background. Moreover, new measures of bilingualism and analytical approaches are helping researchers interrogate the complexities of specific processing issues. Indeed, our review of the bilingualism/multilingualism literature confirms the increased appreciation researchers have for the range of factors-beyond whether someone speaks one, two, or more languages-that impact specific cognitive processes. Here, we highlight some of the most salient of these, and incorporate suggestions for a way forward that likewise encompasses neural perspectives on the topic.

Effects of Lifelong Musicianship on White Matter Integrity and Cognitive Brain Reserve

There is a significant body of research that has identified specific, high-end cognitive demand activities and lifestyles that may play a role in building cognitive brain reserve, including volume changes in gray matter and white matter, increased structural connectivity, and enhanced categorical perception. While normal aging produces trends of decreasing white matter (WM) integrity, research on cognitive brain reserve suggests that complex sensory–motor activities across the life span may slow down or reverse these trends. Previous research has focused on structural and functional changes to the human brain caused by training and experience in both linguistic (especially bilingualism) and musical domains. The current research uses diffusion tensor imaging to examine the integrity of subcortical white matter fiber tracts in lifelong musicians. Our analysis, using Tortoise and ICBM-81, reveals higher fractional anisotropy, an indicator of greater WM integrity, in aging musicians in bilateral superior longitudinal fasciculi and bilateral uncinate fasciculi. Statistical methods used include Fisher’s method and linear regression analysis. Another unique aspect of this study is the accompanying behavioral performance data for each participant. This is one of the first studies to look specifically at musicianship across the life span and its impact on bilateral WM integrity in aging.

Lifelong Bilingualism Functions as an Alternative Intervention for Cognitive Reserve Against Alzheimer's Disease

Bilingualism has been reported to significantly delay the onset of dementia and plays an important role in the management of Alzheimer's disease (AD), a condition inducing impairment in the brain network and cognitive decline. Cognitive reserve is associated with the adaptive maintenance of neural functions by protecting against neuropathology. Bilingualism acts as a beneficial environmental factor contributing to cognitive reserve, although some potential confounding variables still need further elucidation. In this article, the relationship between bilingualism and cognitive reserve is discussed, interpreting the advantage of bilingualism in protecting against cognitive decline. In addition, the possible brain and biochemical mechanisms, supporting the advantageous effects of bilingualism in delaying the onset of dementia, involved in bilingualism are reviewed. Effectively, bilingualism can be considered as a pharmacological intervention with no side effects. However, the investigation of the pharmacological parameters of bilingualism is still at an early stage.

Reserva cognitiva e os diferentes perfis de ganho cognitivo em idosos

O objetivo desse estudo foi verificar diferentes perfis de ganho cognitivo em idosos para a reserva cognitiva. Trata-se de uma scoping review, utilizando-se PubMed, Medline, Web of Science, Science Direct, Lilacs, SciELO, PsycInfo, PsycNet e AgeLine como base de dados; restringiu-se a busca entre o ano de 2008 e 2018. Identificou-se 2295 estudos e 51 foram elegíveis para a revisão. Dentre os 51 estudos selecionados, encontrou-se 9 perfis diferentes para manutenção cognitiva, sendo que 5 estudos não especificaram o perfil. Conclusão: Os perfis encontrados representaram relevância para a teoria de reserva cognitiva e forneceram esclarecimentos de como fatores individuais e de vida diária podem fazer o cérebro mais resiliente no envelhecimento e na velhice; no entanto, esses fatores individuais e o modo como eles contribuem para o desenvolvimento da reserva cognitiva e da manutenção da cognição ainda permanecem obscuras na literatura

Cognitive and Neurocognitive Effects From the Unique Bilingual Experiences of Interpreters

For bilinguals, research suggests that both languages are constantly active and competing in the mind, even when only using one. However, this body of work has reported inconclusive results on the long-term effects of the constant parallel activation and use of more than one language on the brain. This has mostly been due to inconsistent comparisons between groups of bilinguals and monolinguals. Not all bilingualisms are the same. The investigation of the use of more than one language over a lifetime offers the opportunity to better understand the consequences of bilingualism on the brain. However, few studies have specifically looked at the long-standing effects of being an interpreter. In this paper, we review theories from the field of Translation and Interpreting Studies and provide a critical review of work that offers insight on the cognitive and neurocognitive effects that seem to arise from the unique, highly-cognitive-demanding practices experienced by interpreters.

Moderation-Mediation Effects in Bilingualism and Cognitive Reserve

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.

Active Bilingualism in Aging: Balanced Bilingualism Usage and Less Frequent Language Switching Relate to Better Conflict Monitoring and Goal Maintenance Ability

OBJECTIVES

Experience-related neuroplasticity suggests that bilinguals who actively manage their two languages would develop more efficient neural organization at brain regions related to language control, which also overlap with areas involved in executive control. Our aim was to examine how active bilingualism-manifested as the regular balanced use of two languages and language switching-may be related to the different domains of executive control in highly proficient healthy older adult bilinguals, controlling for age, processing speed, and fluid intelligence.

METHODS

Participants were 76 community-dwelling older adults who reported being physically and mentally healthy and showed no signs of cognitive impairment. They completed a self-report questionnaire on their language background, two computer measures for previously identified covariates (processing speed as measured by two-choice reaction time (RT) task and fluid intelligence as measured by the Raven's Progressive Matrices), as well as a battery of computerized executive control tasks (Color-shape Task Switching, Stroop, Flanker, and Spatial 2-back task).

RESULTS

Regression analyses showed that, even after controlling for age, processing speed, and fluid intelligence, more balanced bilingualism usage and less frequent language switching predicted higher goal maintenance (nonswitch trials RT in Color-shape Task Switching) and conflict monitoring abilities (global RT in Color-shape Task Switching and Flanker task).

DISCUSSION

Results suggest that active bilingualism may provide benefits to maintaining specific executive control abilities in older adult bilinguals against the natural age-related declines.

Multilingualism and Dementia Risk: Longitudinal Analysis of the Nun Study

BACKGROUND

Multilingualism is associated with enhanced executive function and may thus prevent cognitive decline and reduce the risk of dementia.

OBJECTIVE

To determine whether multilingualism is associated with delayed onset or reduced risk of dementia.

METHODS

Dementia was diagnosed in the Nun Study, a longitudinal study of religious sisters aged 75+ years. Multilingualism was self-reported. Dementia likelihood was determined in 325 participants using discrete-time survival analysis; sensitivity analyses (n = 106) incorporated additional linguistic measures (idea density and grammatical complexity).

RESULTS

Multilingualism did not delay the onset of dementia. However, participants speaking four or more languages (but not two or three) were significantly less likely to develop dementia than monolinguals (OR = 0.13; 95% CI = 0.01, 0.65, adjusted for age, apolipoprotein E, and transition period). This significant protective effect of speaking four or more languages weakened (OR = 0.53; 95% CI = 0.06, 4.91) in the presence of idea density in models adjusted for education and apolipoprotein E.

CONCLUSION

Linguistic ability broadly was a significant predictor of dementia, although it was written linguistic ability (specifically idea density) rather than multilingualism that was the strongest predictor. The impact of language on dementia may extend beyond number of languages spoken to encompass other indicators of linguistic ability. Further research to identify the characteristics of multilingualism most salient for risk of dementia could clarify the value, target audience, and design of interventions to promote multilingualism and other linguistic training as a strategy to reduce the risk of dementia and its individual and societal impacts.

Cognitive Persistence and Executive Function in the Multilingual Brain During Aging

Researchers have debated the extent to which the experience of speaking more than two languages induces long-term neuroplasticity that protects multilinguals from the adverse cognitive effects of aging. In this review, I propose a novel theory that multilingualism affects cognitive persistence, the application of effort to improve performance on challenging tasks. I review recent evidence demonstrating that the cingulo-opercular network, consisting of the bilateral inferior frontal gyrus (IFG) and dorsal anterior cingulate cortex (dACC), supports cognitive persistence. I then show that this same network is involved in multilingual language control and changes with multilingual language experience. While both early and late multilinguals exhibit differences in the cingulo-opercular network compared to monolinguals, I find that early multilinguals have a pattern of decreased dACC activity and increased left IFG activity that may enable more efficient cognitive control, whereas late multilinguals show larger dACC responses to conflict that may be associated with higher cognitive persistence. I further demonstrate that multilingual effects on the cingulo-opercular network are present in older adults and have been implicated in the mitigation of cognitive symptoms in age-related neurodegenerative disorders. Finally, I argue that mixed results in the literature are due, in part, to the confound between cognitive persistence and ability in most executive function tasks, and I provide guidance for separating these processes in future research.

Impact of music-based intervention on verbal memory: an experimental behavioral study with older adults

Normal age-related declines have been reported in different cognitive functions, such as episodic memory. Some environmental factors have the potential to reduce cognitive decline and promote healthy aging. In this research, we employed musical improvisation as a focal music-based intervention to explore its effects as a modulator of verbal memory. We evaluated two types of verbal memory: a neutral one, employing the Rey Auditory Verbal Learning Test (Study 1), and an emotional one, implementing the Spanish version of Affective Norms for English Words (Study 2) in a volunteer group of older adults. After the acquisition of neutral (Study 1) or emotional (Study 2) verbal information, the participants were exposed to musical improvisation (experimental condition) or two control conditions (rhythmic reproduction as a musically active control condition or a rest condition as a passive control condition) for 3 min. Then, memory was evaluated through two memory tasks (immediate and deferred free-recall and recognition tests). In both studies, we compared memory performance among musicians (with five or more years of music training) and non-musicians. We found a significant improvement in neutral verbal memory among participants involved in musical improvisation, who remembered more words than those in the control conditions. Differences were also found according to the musical experience of the sample, with musicians outperforming non-musicians. The current research supports the late-life cognitive benefits of music-based intervention and music training.

Beyond Alzheimer's disease: Can bilingualism be a more generalized protective factor in neurodegeneration?

Bilingualism has been argued to have an impact on cognition and brain structure. Effects have been reported across the lifespan: from healthy children to ageing adults, including clinical (ageing) populations. It has been argued that active bilingualism may significantly contribute to the delaying of the expression of Alzheimer's disease symptoms. If bilingualism plays an ameliorative role against the expression of neurodegeneration in dementia, it is possible that it could have similar effects for other neurodegenerative disorders, including Multiple Sclerosis, Parkinson's and Huntington's Diseases. To date, however, direct relevant evidence remains limited, not least because the necessary scientific motivations for investigating this with greater depth have not yet been fully articulated. Herein, we provide a roadmap that reviews the relevant literatures, highlighting potential links across neurodegenerative disorders and bilingualism more generally.

Meta-Analysis Reveals a Bilingual Advantage That Is Dependent on Task and Age

Debate continues on whether a bilingual advantage exists with respect to executive functioning. This report synthesized the results of 170 studies to test whether the bilingual advantage is dependent on the task used to assess executive functioning and the age of the participants. The results of the meta-analyses indicated that the bilingual advantage was both task- and age-specific. Bilinguals were significantly faster than monolinguals (Hedges' g values ranged from 0.23 to 0.34), and significantly more accurate than monolinguals (Hedges' g values ranged between 0.18 and 0.49) on four out of seven tasks. Also, an effect of age was found whereby the bilingual advantage was larger for studies comprising samples aged 50-years and over (Hedges' g = 0.49), compared to those undertaken with participants aged between 18 and 29 years (Hedges' g = 0.12). The extent to which the bilingual advantage might be due to publication bias was assessed using multiple methods. These were Egger's Test of Asymmetry, Duval and Tweedie's Trim and Fill, Classic Fail-Safe N, and PET-PEESE. Publication bias was only found when using Egger's Test of Asymmetry and PET-PEESE method, but not when using the other methods. This review indicates that if bilingualism does enhance executive functioning, the effects are modulated by task and age. This may arise because using multiple languages has a highly specific effect on executive functioning which is only observable in older, relative to younger, adults. The finding that publication bias was not uniformly detected across the different methods raises questions about the impact that unpublished (or undetected) studies have on meta-analyses of this literature.

Brain Structure in Bilingual Compared to Monolingual Individuals with Alzheimer's Disease: Proof of Concept

BACKGROUND

Bilingualism is increasingly recognized as protective in persons at risk for Alzheimer's disease (AD).

OBJECTIVE

Compare MRI measured brain volumes in matched bilinguals versus monolinguals with AD.

METHODS

This IRB approved study analyzed T1 volumetric brain MRIs of patients with criteria-supported Probable AD. We identified 17 sequential bilinguals (any native language) with Probable AD, matched to 28 (62%) monolinguals on age and MMSE. Brain volumes were quantified with Neuroreader. Regional volumes as fraction of total intracranial volume (TIV) were compared between both groups, and Cohen's D effect sizes were calculated for statistically significant structures. Partial correlations between bilingualism and brain volumes adjusted for age, gender, and TIV.

RESULTS

Bilinguals had higher brain volumes in 37 structures. Statistical significance (p < 0.05) was observed in brainstem (t = 2.33, p = 0.02, Cohen's D = 0.71) and ventral diencephalon (t = 3.01, p = 0.004, Cohen's D = 0.91). Partial correlations showed statistical significance between bilingualism and larger volumes in brainstem (rp = 0 . 37, p = 0.01), thalamus (rp = 0.31, p = 0.04), ventral diencephalon (rp = 0.50, p = 0.001), and pallidum (rp = 0.38, p = 0.01). Bilingualism positively correlated with hippocampal volume, though not statistically significant (rp = 0.17, p = 0.26). No brain volumes were larger in monolinguals.

CONCLUSION

Bilinguals demonstrated larger thalamic, ventral diencephalon, and brainstem volumes compared to matched monolinguals with AD. This may represent a neural substrate for increased cognitive reserve in bilingualism. Future studies should extrapolate this finding into cognitively normal persons at risk for AD.