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Degree of bilingualism predicts age of diagnosis of Alzheimer's disease in low-education but not in highly educated Hispanics
Open accessAbstract
The current study investigated the relationship between bilingual language proficiency and onset of probable Alzheimer's disease (AD) in 44 Spanish-English bilinguals at the UCSD Alzheimer's Disease Research Center. Degree of bilingualism along a continuum was measured using Boston Naming Test (BNT) scores in each language. Higher degrees of bilingualism were associated with increasingly later age-of-diagnosis (and age of onset of symptoms), but this effect was driven by participants with low education level (a significant interaction between years of education and bilingualism) most of whom (73%) were also Spanish-dominant. Additionally, only objective measures (i.e., BNT scores), not self-reported degree of bilingualism, predicted age-of-diagnosis even though objective and self-reported measures were significantly correlated. These findings establish a specific connection between knowledge of two languages and delay of AD onset, and demonstrate that bilingual effects can be obscured by interactions between education and bilingualism, and by failure to obtain objective measures of bilingualism. More generally, these data support analogies between the effects of bilingualism and "cognitive reserve" and suggest an upper limit on the extent to which reserve can function to delay dementia.
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Citations
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BackgroundMethodBrain reserve and dementia: a systematic review
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Items 101–200 of 217
The Social Construction of Dementia
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BackgroundDoes Bilingualism Delay the Development of Dementia
Atkinson, A. (2016) · Journal of European Psychology Students · doi:10.5334/jeps.375 · Cited by 16
“An important factor which may influence the relationship between bilingualism and the development of dementia is the level of proficiency in the second language ( Antoniou, Gunasekera, & Wong, 2013; Gollan et al., 2011; Kavé, Eyal, Shorek, & Cohen-Mansfield, 2008; Kaushanskaya & Prior, 2015; Zied et al., 2004).”
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Examining the relation between bilingualism and age of symptom onset in frontotemporal dementia
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“We note that previous studies have used delayed age at symptom onset, later age at diagnosis, or a combination of the two as proxies of cognitive reserve (Bialystok et al., 2007; Chertkow, Whitehead, Phillips, Wolfson, Atherton & Bergman, 2010; Gollan, Salmon, Montoya & Galasko, 2011).”
Modulatory role of foreign language experience on the Moral Foreign Language Effect
Privitera, A. J., Li, S., Zhou, Y., & Wang, M. (2023) · Bilingualism Language and Cognition · doi:10.1017/s1366728923000275 · Cited by 12
Zhou, Y., & Privitera, A. J. (2024) · International Journal of Bilingualism · doi:10.1177/13670069241229393 · Cited by 13
“While some evidence supports that subjective and objective measures of language proficiency are correlated (Gollan et al., 2011; Grant & Li, 2019; Li et al., 2020; Marian et al., 2007), whether the inclusion of either measure during analysis impacts on results is an underexplored area of inquiry.”
Lifestyle and Alzheimer’s Disease
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How does speaking another language reduce the risk of dementia?
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MethodCognitive Advantages in Adult Turkish Bilingual Immigrants – a Question of the Chicken or the Egg
Nielsen, T. R., Antelius, E., & Waldemar, G. (2019) · Journal of Cross-Cultural Gerontology · doi:10.1007/s10823-019-09375-7 · Cited by 17
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“In addition, we seek to explore the role of biculturalism given the mixed evidence on the protective effects of bilingualism among Hispanic/ Latino adults [13,14].”
BackgroundMultiple sclerosis and bilingualism
Aveledo, F., Higueras, Y., Marinis, T., Bose, A., Pliatsikas, C., Rivera, A. M., Martínez‐Ginés, M. L., García‐Domínguez, J. M., Ros, A. L., Cuello, J. P., et al. (2020) · Linguistic Approaches to Bilingualism · doi:10.1075/lab.18037.ave · Cited by 12
Neuropsychological assessment of mild cognitive impairment in Latinx adults: A scoping review.
Briceño, E. M., Mehdipanah, R., Gonzales, X. F., Langa, K. M., Levine, D. A., Garcia, N. M., Longoria, R., Giordani, B., Heeringa, S. G., & Morgenstern, L. B. (2020) · Neuropsychology · doi:10.1037/neu0000628 · Cited by 15
Assessment of the Hispanic Cognitively Impaired Elderly Patient
Gomez, L. A. R., Jain, F. A., & D’Orazio, L. M. (2017) · Neurologic Clinics · doi:10.1016/j.ncl.2017.01.003 · Cited by 12
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“In contrast, other studies have found that people with dementia perform language tasks similarly in their first and second languages (Hernandez et al., 2001) or perform language tasks the worst when using their dominant language (Gollan et al., 2011).”
BackgroundResultInfluentialCan Speaking More Than One Language Help Prevent Alzheimer’s Disease?
Mendez, M. F. (2023) · Journal of Alzheimer s Disease · doi:10.3233/jad-230285 · Cited by 33
“Some studies, however, indicate a delay in AD only among low-educated (<11 years) bilinguals [195]; whereas, others found a bilingualism-related delay of AD only in immigrant, but not in non-immigrant bilinguals [196, 201].”
InfluentialAlzheimer’s Disease in Bilingual Latinos: Clinical Decisions for Diagnosis and Treatment Planning
Díaz‐Santos, M., Yáñez, J., & Suárez, P. (2021) · Journal of Health Service Psychology · doi:10.1007/s42843-021-00050-5 · Cited by 9
Primary Progressive Aphasia in Bilinguals and Multilinguals
Malcolm, T. R., Lerman, A., Korytkowska, M., Vonk, J. M. J., & Obler, L. K. (2019) · doi:10.1002/9781119387725.ch28 · Cited by 9
Kamalyan, L., Guareña, L. A., Díaz‐Santos, M., Suárez, P., Cherner, M., Alcorn, M. Y. G., Umlauf, A., Franklin, D. R., Mindt, M. R., Fortuny, L. A. I., et al. (2021) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617721001028 · Cited by 8
“The important question of disentangling which type of measure might more accurately capture the effect of bilingualism on cognition (Gollan et al., 2012, 2011; Rivera Mindt et al., 2008; Suarez et al., 2014; Surrain & Luk, 2019) would be best addressed in future research that includes bilingualism…”
BackgroundRothman, J. (2024) · Bilingualism Language and Cognition · doi:10.1017/s1366728924000026 · Cited by 8
“…the same direction: bilingual-ism correlates with later onset of symptoms and, thus, diagnosis of dementia by as much as 5-7 years relative to comparable mono-linguals (Anderson et al., 2020; Brini et al., 2020, although other factors can mitigate such as SES indicators, e.g., Gollan et al., 2011).”
BackgroundInterpreting cognitive decline in the face of cognitive reserve
Bialystok, E., Anderson, J. A. E., & Grundy, J. G. (2018) · Linguistic Approaches to Bilingualism · doi:10.1075/lab.18040.bia · Cited by 9
Cognitive reserve and dementia A scientometric review
Pestana, M. H. D. A. P. E., & Sobral, M. (2019) · Dementia & Neuropsychologia · doi:10.1590/1980-57642018dn13-010001 · Cited by 8
Event-related potentials reveal increased dependency on linguistic context due to cognitive aging.
la Roi, A., Sprenger, S., & Hendriks, P. (2019) · Journal of Experimental Psychology Learning Memory and Cognition · doi:10.1037/xlm0000777 · Cited by 8
Liu, Y. C., Yip, P. K., Fan, Y.-M., & Meguro, K. (2012) · PubMed · Cited by 7
Aging in Bilinguals: Normal and Abnormal
Lerman, A., & Obler, L. K. (2017) · Springer eBooks · doi:10.1007/978-3-319-64099-0_8 · Cited by 7
Selective cognitive effects of multilingualism emerge in visuospatial working memory in later life
Maurice, O. R., Jones, C., & Harris, C. B. (2025) · Scientific Reports · doi:10.1038/s41598-025-32091-x · Cited by 6
“peers 10–14,18, 19 .”
Clark, A. L., Reyes, A., Breton, J., Petersen, M. E., O’Bryant, S. E., Grasso, S. M., & for the HABS-HD Study Team (2024) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617724000547 · Cited by 6
“…identified as an important factor that may enhance cognitive and neural reserve, and significant efforts have focused on characterizing the posited benefits of bilingualism on AD in recent years (Calvo et al., 2023; Gollan et al., 2011; Liu & Wu, 2021; Perani & Abutalebi, 2015; Raji et al., 2020).”
Bilingualism in Parkinson’s disease: Relationship to cognition and quality of life
Fishman, K. N., Roberts, A., Orange, J. B., Sunderland, K. M., Marras, C., Tan, B., Steeves, T. D. L., Kwan, D. T., Lang, A. E., Grimes, D., et al. (2021) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2021.1902946 · Cited by 8
“Another limitation is that proficiency ratings were provided using subjective self-report rather than objective testing in both languages (e.g. administering the BNT in both languages; Gollan et al., 2011).”
BackgroundThe Impact of Bilingualism on Conflict Control
Mendes, G., & María, C. (2015) · Otago University Research Archive (University of Otago) · Cited by 6
Freilich, B. M., Scharaga, E. A., & Holtzer, R. (2025) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acaf010 · Cited by 5
Two bee oar knot too be: the effects of orthography and bilingualism on spoken homophone production
Barr, P., Biedermann, B., & Nickels, L. (2022) · Language Cognition and Neuroscience · doi:10.1080/23273798.2022.2027992 · Cited by 5
“There is also an inevitable reduction in the frequency of words for bilingual participants, given that they speak the same amount as monolingual participants, but this is divided across two sets of lexical items (Gollan et al., 2008, 2011).”
BackgroundThalamus as a neural marker of cognitive reserve in bilinguals with frontotemporal dementia
Thanissery, N., Arshad, F., Khokhar, S. K., Kenchaiah, R., Singh, V., Ramakrishnan, S., Saini, J. S., Srinivasan, N., Bapi, R. S., & Alladi, S. (2025) · Bilingualism Language and Cognition · doi:10.1017/s136672892500015x · Cited by 4
“Evidence for this association came initially from studies on bilingualism and age at the onset of dementia especially among persons with Alzheimer ’ s disease (AD) (Alladi et al., 2013; Anderson et al., 2020; Bialystok et al., 2007; Craik et al., 2010; Gollan et al., 2011).”
AoA-L2 and Usage-L2 modulate the functional neuroplasticity of the subcortex
Liu, X., Gao, Z., Liu, W., He, X., & Wang, N. (2023) · Brain and Language · doi:10.1016/j.bandl.2023.105323 · Cited by 4
Effect of bilingualism on visual tracking attention and resistance to distraction
Janić, A., Cavanagh, P., & Rivest, J. (2020) · Scientific Reports · doi:10.1038/s41598-020-71185-6 · Cited by 4
Neuropsychological Assessment of Dementia
Salmon, D. P. (2019) · Cambridge University Press eBooks · doi:10.1017/9781108235433.030 · Cited by 5
IQ Testing and the Hispanic Client
Thaler, N. S., & Jones-Forrester, S. (2012) · Springer eBooks · doi:10.1007/978-1-4614-4412-1_6 · Cited by 4
Cooley, S. (2020) · Wiley eBooks · doi:10.1002/9781119057840.ch34 · Cited by 5
Elliott, M. R., Mungas, D., Rentería, M. A., Whitmer, R. A., DeCarli, C. S., & Fletcher, E. M. (2024) · Bilingualism Language and Cognition · doi:10.1017/s1366728924000105 · Cited by 3
Strangmann, I. M., Briceño, E. M., Petrosyan, S., Meijer, E., Nichols, E. L., Kobayashi, L. C., Narayanan, S. S., Lee, J., & Rentería, M. A. (2025) · Alzheimer s & Dementia Behavior & Socioeconomics of Aging · doi:10.1002/bsa3.70018 · Cited by 3
“28 However, a recent study by our group found the opposite pattern, with multilingual older adults who had higher levels of education experiencing greater cognitive benefits compared to their peers with lower levels of education.”
Bilingualism across the adult life-span: Age and language usage are continuous variables
Burkert, S. I. (2016) · EngagedScholarship @ Cleveland State University (Cleveland State University) · Cited by 3
Gasquoine, P. G., Weimer, A. A., & Lawton, D. M. (2015) · Cortex · doi:10.1016/j.cortex.2015.05.015 · Cited by 3
Reserva cognitiva e os diferentes perfis de ganho cognitivo em idosos
Brandebusque, J. C., Cipolli, G. C., Alonso, V., Defanti, F. M. G., & Cachioni, M. (2020) · Psico · doi:10.15448/1980-8623.2020.4.33842 · Cited by 3
Bilingualism (multilingualism) Helps Resist Alzheimer's Disease?
Cheng, K., Deng, Y., & Yao, D. (2014) · Advances in Psychological Science · doi:10.3724/sp.j.1042.2014.01723 · Cited by 3
“…13 年的研究, 将老人会说语言的数目与各自各个 阶段认知水平数据进行了统计分析, 在匹配了诸 多人口统计学变量(例如, 年龄、性别、出生地、 移民年龄和教育水平)后发现, 会说语言的数目能 预测各项认知测验 (特别是筛选试验 cognitivescreening test)的成绩, 换言之, 老人会说的语言 越多, 其认知水平越高。因此, 就目前掌握的文献 来说, 双(多)语经验对老年人认知能力的正面影 响比较明显。 2 双(多)语经验抵御老年痴呆症的研究 进展与思考 2007年, 加拿大 Bialystok, Craik和 Freeman 等人研究了多伦多一所医院中 184…”
Multilingualism across the lifespan and its impact on brain health in the elderly
Leca, I. (2017) · European Journal of Applied Linguistics · doi:10.1515/eujal-2017-0015 · Cited by 3
“…Lavin, Thompson et al., 2010; Poulin-Dubois, Blaye, Coutya et al., 2011; Morales, Calvo & Bialystok, 2013; Greenberg, Bellana & Bialystok, 2013; Gordon, 2015; Crivello, Kuzyk, Rodriguez et al., 2016; Bialystok & Barac, 2012), young adults (Costa, Hernández & Sebastián-Gallés, 2008; Soveri,…”
Lasekan, O. A. (2020) · Space and Culture India · doi:10.20896/saci.v8i1.623 · Cited by 5
“For example, language therapy treatment for Alzheimer patient since both the dominant and recessive language is affected by the disease (Gollan et al., 2011).”
BackgroundModeration-Mediation Effects in Bilingualism and Cognitive Reserve
Heredia, R. R., Blackburn, A. M., & Vega, L. A. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.572555 · Cited by 4
“While it is true that theoretically important variables in an experiment, for example, can be treated as covariates, this can only be true if the factor is a quantitative one (e.g., Gollan et al., 2011).”
BackgroundInfluentialLi, J., Han, Y., Lam, J. C. K., Li, V. O. K., Matthews, S., Cheung, L. Y. L., Yip, V., Downey, J., Chan, D. T.-M., & Gozes, I. (2021) · Preprints.org · doi:10.20944/preprints202102.0502.v1 · Cited by 3
“Gollan et al. (2011) AD (n=44): B = 44 education, degree of bilingualism Pearson bivariate correlations Bialystok et al. (2014) MCI (n=74): M = 38, B = 36 AD (n=75): M = 35, B = 40 Immigration, education, lifestyles (diet, alcohol, smoking, physical and social activities) Two-way ANOVA, Partial…”
Gayosso, N. V., Omaña-Covarrubias, A., Castro, A. T. N., Pontigo, L. L., Gurrola, M. D. R. A., & Pérez, B. M. P. (2025) · Diseases · doi:10.3390/diseases13100317 · Cited by 2
“This ability to possess sufficient mental stock that can prevent harmful effects of aging on our cognition is known as “cognitive reserve” [11].”
Rentería, M. A., Strangmann, I. M., Saidi, L. G., Subina, M. M., Paplikar, A., Dash, T., Costa, A. S., Lahiri, D., Page, Z. A., Bose, A., et al. (2026) · Alzheimer s & Dementia · doi:10.1002/alz.71393 · Cited by 2
Hemispheric Differences: The Bilingual Brain
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The Bilingual Advantage and the Language Background Bias
Angelis, G. D. (2019) · Theory and Practice of Second Language Acquisition · doi:10.31261/tapsla.7554 · Cited by 2
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BILINGUISMO INFANTIL. UM LEGADO VALIOSO DO FENÓMENO MIGRATÓRIO
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Translation, Interpreting, and the Bilingual Brain
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Beyond Alzheimer’s Disease: Bilingualism and Other Types of NeurodegenerationPreprint
Voits, T., Pliatsikas, C., Robson, H., & Rothman, J. (2019) · doi:10.31234/osf.io/5qng4 · Cited by 2
Spoken word processing in bilingual older adults
Titone, D. A., Mercier, J., Sudarshan, A., Pivneva, I., Gullifer, J. W., & Baum, S. R. (2020) · Linguistic Approaches to Bilingualism · doi:10.1075/lab.18028.tit · Cited by 1
The Role of Memory in Communication
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Properties of child-directed speech in bilingual parents
Li, Y., & Onnis, L. (2021) · Linguistic Approaches to Bilingualism · doi:10.1075/lab.20011.li · Cited by 1
Pahlavannezhad, M. R., & Heidarypur, M. (2021) · Onomázein Revista de lingüística filología y traducción · doi:10.7764/onomazein.51.01 · Cited by 1
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“Gollan et al. (2011) found that the delay in AD onset due to bilingualism was evident only in individuals with lower education levels, whereas highly educated Spanish-English bilinguals in the United States did not experience the same advantage.”
Bilingualism and individual differences in short-term ordered serial recall
Caissie-Gilbert, A., Guitard, D., & Saint‐Aubin, J. (2026) · Memory · doi:10.1080/09658211.2026.2657536 · Cited by 1
“In effect, although bilingualism has long been considered as a dichotomous variable, the prevalent view is now to consider it to be a continuous variable (de Bruin, 2019; Gollan et al., 2011; Incera & McLennan, 2017).”
Bilingualism and Language Education to Improve the Cognitive Health of Older Persons
Meulenberg, C. J. W. (2021) · Andragoška spoznanja · doi:10.4312/as/9577 · Cited by 1
“Gollan et al. (2011) Retrospective longitudinal; N=44, Hispanic older persons; B prefer English=22, 75.1y; B prefer Spanish=22, 77.1y University of California, San Diego Alzheimer’s Disease Research Center, San Diego, California, United States, between 2002–2007; Spanish, English Higher degrees of…”
BackgroundResultInfluentialWray, A. (2020) · Oxford University Press eBooks · doi:10.1093/oso/9780190917807.003.0008 · Cited by 1
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“One of the results they concluded that bilingual effects can be obscured by interactions between education and bilingualism (Gollan et al., 2011).”
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“An example (see below for a more detailed dislow educational levels [Gollan et al., 2011] or in immigrants [Chertkow et al., 2010].”
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Metadata
- Authors
- Gollan, T. H., Salmon, D. P., Montoya, R. I., & Galasko, D. R.
- Affiliations
- University of California San Diego (US)
- Corresponding author
- Gollan, Tamar H.
- Venue
- Neuropsychologia
- Publisher
- Elsevier BV
- Published
- 2011-12
- Volume
- 49
- Issue
- 14
- Pages
- 3826-3830
- ISSN
- 0028-3932 (ISSN-L)
- PMC
- PMC3223277
- OpenAlex
- W2022236503
- Cited by
- 218
- References
- 17
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 6 · 2023: 14 · 2022: 8 · 2021: 20 · 2020: 37 · 2019: 28 · 2018: 14 · 2017: 17 · 2016: 22 · 2015: 10 · 2014: 14 · 2013: 10 · 2012: 5
- FWCI
- 6.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neuropsychologia (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (P50AG005131, P50-AG05131)
- National Institute on Deafness and Other Communication Disorders (R01DC011492)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD050287)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- bilingualism, Alzheimer's disease, age at diagnosis, Spanish-English bilinguals, educational attainment, cognitive reserve, Boston Naming Test, dementia onset, Hispanic older adults
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Alzheimer Disease, Educational Status, Female, Hispanic or Latino, Humans, Male, Names, Neuropsychological Tests, Age of Onset, Multilingualism
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