Linguistic Ability in Early Life and Cognitive Function and Alzheimer's Disease in Late Life: Findings From the Nun Study
Abstract
Objective. —To determine if linguistic ability in early life is associated with cognitive function and Alzheimer's disease in late life. Design. —Two measures of linguistic ability in early life, idea density and grammatical complexity, were derived from autobiographies written at a mean age of 22 years. Approximately 58 years later, the women who wrote these autobiographies participated in an assessment of cognitive function, and those who subsequently died were evaluated neuropathologically. Setting. —Convents in the United States participating in the Nun Study; primarily convents in the Milwaukee, Wis, area. Participants. —Cognitive function was investigated in 93 participants who were aged 75 to 95 years at the time of their assessments, and Alzheimer's disease was investigated in the 14 participants who died at 79 to 96 years of age. Main Outcome Measures. —Seven neuropsychological tests and neuropathologically confirmed Alzheimer's disease. Results. —Low idea density and low grammatical complexity in autobiographies written in early life were associated with low cognitive test scores in late life. Low idea density in early life had stronger and more consistent associations with poor cognitive function than did low grammatical complexity. Among the 14 sisters who died, neuropathologically confirmed Alzheimer's disease was present in all of those with low idea density in early life and in none of those with high idea density. Conclusions. —Low linguistic ability in early life was a strong predictor of poor cognitive function and Alzheimer's disease in late life. (JAMA. 1996;275:528-532)
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Linguistic structure and complexity can serve as a strong predictor for the onset of AD and potentially other forms of cognitive impairment.
“This work was groundbreaking in showing that linguistic structure and complexity can serve as a strong predictor for the onset of AD and potentially other forms of cognitive impairment.”
From A Review of Automated Speech and Language Features for Assessment of Cognitive and Thought Disorders (2020) · cites this paper as [66]
In Snowdon et al., about 80% of participants whose writings lacked linguistic complexity developed AD or had mental and cognitive disabilities in older age.
“Roughly 80% of the participants that were determined to lack linguistic complexity in their writings developed AD or had mental and cognitive disabilities in their older age.”
From A Review of Automated Speech and Language Features for Assessment of Cognitive and Thought Disorders (2020) · cites this paper as [66]
Snowdon et al. found that low idea density in early life was a particularly strong predictor of reduced cognitive ability or AD in later life.
“In particular, the study found that low idea density in early life was a particularly strong predictor of reduced cognitive ability or the presence of AD in later life.”
From A Review of Automated Speech and Language Features for Assessment of Cognitive and Thought Disorders (2020) · cites this paper as [66]
The mitochondrial cascade hypothesis better accommodates data that argue early adult cognitive markers predict AD risk long before plaques and probably Aβ changes occur.
“For this reason, we believe our hypothesis better accommodates data that argue early adult cognitive markers predict AD risk long before plaques and probably Aβ changes occur [246, 247].”
From The Alzheimer’s disease mitochondrial cascade hypothesis: progress and perspectives (2014) · cites this paper as [246]
Various studies suggest the pre-dementia period of cognitive decline lasts at least a decade and perhaps many decades.
“Various studies suggest this pre-dementia period of cognitive decline lasts at least a decade and perhaps even many decades [83–86].”
From Brain aging, Alzheimer's disease, and mitochondria (2011) · cites this paper as [83]
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Cited by 696
- Authors
- Snowdon, D. A.
- Corresponding author
- Snowdon, David A.
- ORCID
- Snowdon, David A.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1996-02-21
- Volume
- 275
- Issue
- 7
- Pages
- 528
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W4293569649
- Cited by
- 696
- References
- 0
- Citations by year
- 2026: 22 · 2025: 23 · 2024: 16 · 2023: 29 · 2022: 26 · 2021: 28 · 2020: 32 · 2019: 36 · 2018: 28 · 2017: 36 · 2016: 24 · 2015: 26 · 2014: 26 · 2013: 17 · 2012: 26
- FWCI
- 14.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- Funders
- National Institute on Aging (K04 AG00553, R01AG09862, K04AG00443)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Keywords
- language skills, idea density, grammatical complexity, cognitive function, Alzheimer's disease, late-life cognitive decline, neuropathology, Nun Study, women religious
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