Multilingualism as a factor of resilience to Alzheimer's disease and related dementias in India

多语言使用是印度阿尔茨海默病和相关痴呆症恢复能力的一个因素

• 批准号: 10584373
• 负责人: Leon Aksman
• 金额: $ 81.74万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-15 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10584373
• 关键词: Address; Age; Age Years; Aging; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Amyloid; Attention; Biological; Biological Markers; Blood; Blood Tests; Blood specimen; Brain region; Buffers; Cognition; Cognitive; Cognitive aging; Communities; Country; Data; Dementia; Diagnostic; Education; Elderly; Environmental Risk Factor; Family; Frequencies; Funding; Geographic Locations; Health; Healthcare; Impaired cognition; Income; India; Individual; Intervention; Interview; Investigation; Language; Language Development; Life Cycle Stages; Linguistics; Magnetic Resonance Imaging; Measures; Memory; Methodology; Multilingualism; Outcome; Participant; Pathology; Pathway interactions; Personal Satisfaction; Persons; Plasma; Population; Population Heterogeneity; Prevention; Public Health; Recording of previous events; Reporting; Research; Risk; Risk Factors; Role; Sampling; Schedule; Schools; Social Class; Socioeconomic Status; Standardization; Subgroup; Testing; Thick; Variant; Venous; Work; bilingualism; brain health; brain volume; cerebral atrophy; cognitive function; cognitive reserve; cognitive testing; dementia risk; ethnic diversity; executive function; experience; health determinants; insight; literacy; low and middle-income countries; machine learning method; modifiable risk; mortality; neuroimaging; neuroimaging marker; neuropathology; promote resilience; protective effect; resilience; resilience factor; response; rural residence; social; social culture; sociocultural determinant; sociodemographics; socioeconomics; tau Proteins; white matter; Address; Age; Age Years; Aging; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Amyloid; Attention; Biological; Biological Markers; Blood; Blood Tests; Blood specimen; Brain region; Buffers; Cognition; Cognitive; Cognitive aging; Communities; Country; Data; Dementia; Diagnostic; Education; Elderly; Environmental Risk Factor; Family; Frequencies; Funding; Geographic Locations; Health; Healthcare; Impaired cognition; Income; India; Individual; Intervention; Interview; Investigation; Language; Language Development; Life Cycle Stages; Linguistics; Magnetic Resonance Imaging; Measures; Memory; Methodology; Multilingualism; Outcome; Participant; Pathology; Pathway interactions; Personal Satisfaction; Persons; Plasma; Population; Population Heterogeneity; Prevention; Public Health; Recording of previous events; Reporting; Research; Risk; Risk Factors; Role; Sampling; Schedule; Schools; Social Class; Socioeconomic Status; Standardization; Subgroup; Testing; Thick; Variant; Venous; Work; bilingualism; brain health; brain volume; cerebral atrophy; cognitive function; cognitive reserve; cognitive testing; dementia risk; ethnic diversity; executive function; experience; health determinants; insight; literacy; low and middle-income countries; machine learning method; modifiable risk; mortality; neuroimaging; neuroimaging marker; neuropathology; promote resilience; protective effect; resilience; resilience factor; response; rural residence; social; social culture; sociocultural determinant; sociodemographics; socioeconomics; tau Proteins; white matter

Project Summary/Abstract By 2050, two-thirds of older individuals with dementia will live in low-and middle-income countries (LMICs). As LMICs continue to experience a reduction in mortality, it is critical to determine factors that confer protection and resilience toward Alzheimer’s disease and related dementias (ADRD). Some studies find that bilinguals are at reduced ADRD risk compared to monolinguals, but other studies do not find evidence of a bilingual advantage. The rationale for this study is that the equivocal findings of prior research has been driven largely by methodological inconsistencies that limit our understanding of bilingualism’s role in cognitive aging such as: 1) inadequate control for potential confounders that limit our ability to infer whether bilingualism has a direct effect on cognition or whether these relationships are due to environmental and sociocultural factors, 2) limited inclusion of markers of neuropathology, and 3) little attention given to within-group differences among bilinguals, such as age of second language (L2) acquisition, proficiency, frequency of language use, number of languages spoken, and diversity of language families. India offers a unique opportunity to study the role of bilingualism in cognitive reserve and resilience, given its rich linguistic and sociocultural diversity across the country. The overall aim of the study is to leverage the unique features of India’s linguistic and sociodemographic landscape to discern whether bilingualism modifies the association between blood-based and neuroimaging biomarkers of ADRD and cognition and cognitive decline. This study will analyze available plasma-based measures of amyloid and tau pathologies, MRI, and cognitive assessments from the Longitudinal Aging Study in India–Diagnostic Assessment of Dementia (LASI-DAD), a large, population-representative study of ageing and dementia in India. Specifically, the project will 1) determine whether bilingualism modifies the association between ADRD biomarkers (blood-based or neuroimaging) and cognitive outcomes, 2) evaluate whether the protective effect of bilingualism differs across diverse life-course environmental determinants of health, and 3) deconstruct language use within bilinguals in India to understand the mechanisms by which bilingualism confers cognitive reserve against biological risk of ADRD. We hypothesize that bilingualism will buffer the effects of blood AD-biomarkers (amyloid, and tau plasma levels), cortical atrophy, and white matter integrity on baseline cognition and rate of cognitive decline compared to monolinguals in the domains of memory, language, and executive functioning. In addition, by deconstructing bilingualism, we hypothesize that earlier age of L2 acquisition, higher bilingual proficiency, greater daily multiple language use, higher number of languages acquired, and greater distance between language families will confer cognitive reserve, independent of confounding sociocultural factors (i.e., education, socioeconomic status). This proposal will enhance the field of ADRD by uncovering the underlying mechanisms of resilience to ADRD that may be modifiable and transferable to other populations.

项目摘要/摘要 到2050年，患有痴呆症的老年人中有三分之二将生活在中低收入国家（LMIC）。作为 LMIC继续经历降低死亡率，确定赋予保护和的因素至关重要 对阿尔茨海默氏病和相关痴呆症（ADRD）的韧性。一些研究发现双语是 与单语言相比，ADRD风险降低，但其他研究没有发现双语优势的证据。 这项研究的理由是，先前研究的同等发现主要是由 方法论上的不一致限制了我们对双语主义在认知衰老中的作用的理解，例如：1） 对潜在混杂因素的控制不足，这些混杂因素限制了我们推断双语是否具有直接影响的能力 关于认知或这些关系是由于环境和社会文化因素而引起的，2）有限 包括神经病理学的标记，3）几乎没有注意双语者之间的组内差异， 例如第二语言年龄（L2）获取，熟练程度，语言使用频率，语言数量 口语和语言家庭的多样性。印度提供了一个独特的机会来研究双语中的作用 鉴于全国各地的语言和社会文化多样性，认知储备和韧性。总体 这项研究的目的是利用印度语言和社会人口统计学景观的独特特征 辨别双语是否修改了基于血液和神经影像学之间的关联 ADRD和认知和认知能力下降。这项研究将分析可用的基于等离子体的淀粉样蛋白测量 以及来自印度纵向衰老研究的TAU病理，MRI和认知评估 痴呆症评估（LASI-DAD），这是一项大型，人口代表性的对印度衰老和痴呆症的研究。 具体而言，该项目将1）确定双语是否修改了ADRD之间的关联 生物标志物（血液或神经影像学）和认知结果，2） 双语主义在潜水员生活中的环境决定者之间有所不同，3）解构语言 在印度的双语者中使用，以了解双语供认认知储备的机制 反对ADRD的生物风险。我们假设双语主义将缓解血ad生物标志物的影响 （淀粉样蛋白和Tau血浆水平），基线认知和速率上的皮质萎缩和白质完整性 与记忆，语言和执行功能领域中的单语言相比，认知能力下降。在 补充，通过解构双语主义，我们假设L2的早期年龄，更高的双语 熟练程度，每日多种语言使用，获取的语言数量更高，距离更大 语言家庭之间将赋予认知储备，而与混杂的社会文化因素无关（即 教育，社会经济地位）。该提案将通过揭示基础来增强ADRD的领域 对ADRD的弹性机制，可以修改并转移到其他人群中。