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

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.

项目概要/摘要 到 2050 年，三分之二的痴呆症老年人将生活在低收入和中等收入国家 (LMIC)。 中低收入国家的死亡率持续下降，因此确定提供保护和保护的因素至关重要 一些研究发现，双语者对阿尔茨海默病和相关痴呆症（ADRD）的恢复能力处于最高水平。 与单语者相比，ADRD 风险降低，但其他研究并未发现双语优势的证据。 这项研究的基本原理是，先前研究的模棱两可的结果很大程度上是由 方法上的不一致限制了我们对双语在认知老化中的作用的理解，例如：1) 对潜在混杂因素的控制不足，限制了我们推断双语是否有直接影响的能力 认知或这些关系是否归因于环境和社会文化因素，2）有限 纳入神经病理学标记，3）很少关注双语者之间的组内差异， 例如第二语言 (L2) 习得年龄、熟练程度、语言使用频率、语言数量 印度的口语和语系多样性为研究双语的作用提供了独特的机会。 鉴于全国丰富的语言和社会文化多样性，认知储备和复原力。 该研究的目的是利用印度语言和社会人口景观的独特特征 辨别双语是否会改变血液生物标志物和神经影像生物标志物之间的关联 ADRD 与认知和认知能力下降 本研究将分析现有的基于血浆的淀粉样蛋白测量方法。 印度纵向衰老研究中的 tau 蛋白病理学、MRI 和认知评估——诊断 痴呆症评估 (LASI-DAD)，一项针对印度老龄化和痴呆症的大型人口代表性研究。 具体来说，该项目将 1) 确定双语是否会改变 ADRD 之间的关联 生物标志物（基于血液或神经影像）和认知结果，2）评估是否具有保护作用 双语在健康的不同生命过程环境决定因素中有所不同，并且 3) 解构语言 在印度的双语者中使用它来了解双语赋予认知储备的机制 我们发现双语可以缓冲血液 AD 生物标志物的影响。 （淀粉样蛋白和 tau 血浆水平）、皮质萎缩和白质完整性对基线认知和认知率的影响 与单语者相比，他们在记忆、语言和执行功能方面的认知能力下降。 此外，通过解构双语，我们追求二语习得年龄越早、双语能力越高。 熟练程度、日常多语言使用量更大、获得的语言数量更多、距离更远 语言家族之间的差异将赋予认知储备，独立于混杂的社会文化因素（即， 该提案将通过揭示潜在的问题来增强 ADRD 领域。 ADRD 的恢复机制可以修改并转移到其他人群。