Bilingual people are twice as likely to recover from a stroke, study finds

http://www.sciencealert.com/bilingual-people-are-twice-as-likely-to-recover-from-a-stroke-study-finds

by hunglee2 • 11 years ago

132 56 11 years ago

Abstract of referenced journal article

Background and Purpose—Bilingualism has been associated with slower cognitive aging and a later onset of dementia. In this study, we aimed to determine whether bilingualism also influences cognitive outcome after stroke.

Methods—We examined 608 patients with ischemic stroke from a large stroke registry and studied the role of bilingualism in predicting poststroke cognitive impairment in the absence of dementia.

Results—A larger proportion of bilinguals had normal cognition compared with monolinguals (40.5% versus 19.6%; P<0.0001), whereas the reverse was noted in patients with cognitive impairment, including vascular dementia and vascular mild cognitive impairment (monolinguals 77.7% versus bilinguals 49.0%; P<0.0009). There were no differences in the frequency of aphasia (monolinguals 11.8% versus bilinguals 10.5%; P=0.354). Bilingualism was found to be an independent predictor of poststroke cognitive impairment.

Conclusions—Our results suggest that bilingualism leads to a better cognitive outcome after stroke, possibly by enhancing cognitive reserve. (Stroke. 2016;47:00-00. DOI: 10.1161/STROKEAHA.115.010418.) Key Words: aphasia ◼ dementia, vascular ◼ language ◼ risk factors ◼ stroke

http://stroke.ahajournals.org/content/early/2015/11/19/STROK...

Original press release

http://www.ed.ac.uk/news/2015/stroke-191115

nonbel• 11 years ago

This is probably some kind of testing artifact. Table 1 shows that 64.3% of monolinguals were literate compared to 92.9% of bilinguals. Then in the supplemental methods we see that illiterates took a different test than literates. They defined cognitive impairment as a score of under mean - 2*SD measured from groups consisting of ~80% literates:

"The process of adaptation included culturally appropriate modifications of the original English version of ACE-R by examining each item for cultural relevance, translatability, comparable difficulty and adaptability with an aim of tapping the domain identical to the original version. Translations and back translations, and pilot testing were done based on standard procedures.3 ACE-R was adapted for the illiterate population by modifying literacy dependent items.4

Normative data and cut off values in the local languages- Telugu and Hindi were developed by administering the test to healthy controls. Telugu control group subjects consisted 907 literates and 199 illiterates, and Hindi control group subjects consisted 436 literates and 109 illiterates. Mean and SD for total scores and sub-scores in each domain were calculated across 4 age groups (20-39, 40-59, 60-79, 80 and above), and three education levels (>12 years, 4-12 years, 0-3 years), using standard formulae of Mean-2SD. Impairment in cognition was defined if the score on the ACE-R sub-domains was less than 2.00 SD below the mean level of age and education-matched norms."

Then we have the arbitrary age groups and education levels which makes this look p-hacked, there needs to be some assessment of how much those arbitrary choices affect the conclusions.

wangii• 11 years ago

great, I know both HTML and CSS, and some javascript.

seriously though, I think it would also apply to programmers using both functional and procedural languages.

wibr• 11 years ago

I think most programmers can learn a new programming language to reasonable "fluency" in a few weeks, for natural languages it's more like a few years. Totally different except when you think of formal terms like vocabulary, syntax etc. which can be found in both and may have led to the term "programming language".

hollerith• 11 years ago

The chairman of the department of English at my local community college told me that it takes the average student of English as a second language 7 years to get good enough that a native English speaker might want to have a conversation with the student.

yAnonymous• 11 years ago

So you're quadrilingual? I got bad news for you...

blfr2• 11 years ago

This switching offers practically constant brain training which may be a factor in helping stroke patients recover.

Another hypothesis would be that being in better neural shape to being with allowed them to become bilingual. Can someone... obtain the full pdf? Do the authors try to control this factor?

khgvljhkb2• 11 years ago

I'd wager most bilinguals are so not because they thought it would be a cool self-improvement project. I speak English because all the good movies are made in the US, and German because I live in Germany, and Swedish because that is what my mother and father spoke to me.

drd93• 11 years ago

I would support your statement as well. I know three languages: one as my native language, other as my country's only official language, and the last one (English) is my general purpose language, meaning I use at to surf web, to study books, to watch films/series, to code, etc..

Would I learn any other language if I would be born in English society and English family? Doubt it. Maybe some other mainstream language just for fun, but it wouldn't count as bilingual as I wouldn't push myself hard enough to learn it.

blfr2• 11 years ago

There are however plenty of Germans who are not fluent in English despite having access to all the same cool American movies as you did.

phreeza• 11 years ago

I think the PDF is open access? [0] Of course it is hard to control for 'neural shape', but they seem to control for both education and occupational status, which seem like pretty decent proxies to me.

[0] http://stroke.ahajournals.org/content/early/2015/11/19/STROK...

AnAfrican• 11 years ago

I bet most multilingual people didn't have to become mulitlingual.

grondilu2• 11 years ago

Not quite related, but I'm wondering what it means to be bilingual. I mean, does the use of English on internet count? For instance, I'm French and I spend most of my time on the "english" internet, including YouTube, reddit, HN, IRC... I'd say 95% of my activity on the web is in English. I also watch american TV series and movies without subtitles.

I understand english quite well and yet, I haven't spoken English for many years. Does that count?

saint_fiasco• 11 years ago

I'm imagining some poor anon or redditor getting a stroke and only being able to communicate through memes.

I think if you can think in English, that counts as bilingual. Ever had a dream in English?

55555• 11 years ago

I can read fluently in Thai but writing is nearly impossible. I can understand (listen) with significant fluency but speaking is much harder. These are four very different skills, trust me.

arbitrage• 11 years ago

Fluency in another language is typically understood to mean all aspects of the language ... reading, writing, speaking, and listening. You're not fully (bi|tri|quad)lingual without being able to do some part of those skills in another language.

That being said, you don't need to be the worlds best writer or speaker. You just need to have those skills.

barkingcat2• 11 years ago

Certain languages are more difficult to master in the 4 quadrants that you refer to (read / write / speak / listen) - sometimes languages are much much more difficult to write than to read - it's important to keep those distinctions in mind when speaking about fluency in other languages because not all languages are like English / Roman / have an alphabet, and it's not fair to say someone is not "fluent" if they can't recall instantaneously how to write the thousands of characters that even a native-speaking child would be able to recall.

I'd say someone is fluent if they can perform and understand communications via the various aspects of language, but I don't think you need to be able to express each one.

(For example, being able to type Chinese on the computer via ping yin and fast computerized lookup is an expression of fluency, even though the person might not know how the stroke directions of the character would work if they had to write on paper unassisted)

oska• 11 years ago

In my opinion, yes. Fluency in a language is comprehension and production. What you wrote above was production of (very) fluent English, which was in turn evidence of good comprehension of the linked article. Fluency in another language implies the ability to dwell ‘naturally’ in the language, and I don't think that your dwelling mostly in the written form of the language would lessen the benefits that this paper suggests bilingualism can bring.

barkingcat2• 11 years ago

Yes, that's exactly what bilingual (or multilingual) means. Doesn't have to be completely fluent or use it everyday, just that you literally know and can communicate in more than one language.

In Europe, it's more likely that any one person is bi- or multi-lingual just because there are more languages in contact with one another through close borders, etc.

In parts of North America, some people only know one language their entire life (whether it be Spanish or English, etc)

jordigh3• 11 years ago

It is quite common (in fact, nearly ubiquitous) for bilinguals to have different domains for each language. For example, you would probably prefer to have a computer conversation in English than in French, but you probably would prefer to speak to your family in French. It is also very common (again, nearly ubiquitous) for bilinguals to have varying degrees of competence in each language.

There isn't an absolute boundary that separates bilinguals from monolinguals. If you're interested in the topic, I've been reading this very interesting book. It's slightly technical, but it's a very interesting summary of many recent studies of bilingualism:

http://ca.wiley.com/WileyCDA/WileyTitle/productCd-EHEP002792...

a-l-c-o3• 11 years ago

I'm in your exact situation.

And as a consequence (or cause) I am now seeing French as inadequate. It's such a verbose and slow language.

I don't deny its rare beauty when used ideally (think poetry, good writers, Francoise Hardy singing).

But in practice, what twisted collective mind could come up and stay with "Qu'est ce que c'est ?" (What is it ?) ? That monster literally translate to "What is this that it is ?".

In a fast and unifying world I am positive French is doomed.

When arguing this with people I always get rebutted with the likes of "French is very rich.. It is just different..but none the less valuable.." I don't think so. English is an efficient superset of french. You can express as much or more subtlety, feelings or facts in English. Take only the vocabulary : It's just larger in English ! (And in fact contains a good chunk of the French).

jordigh3• 11 years ago

But in practice, what twisted collective mind could come up and stay with "Qu'est ce que c'est ?" (What is it ?) ? That monster literally translate to "What is this that it is ?".

But it's only three syllables, like "what is it?" It's also kind of atomic. My French isn't native, but I don't think you can say "qui est ce qui ça est?", if you want to ask "who is it?", i.e. the initial two syllables "qu'est ce que" seem indivisible.

Comparisons about one language being more verbose/complex/harder than another never seem to really hold up under scrutiny. Usually when comparing two languages, one exhibits simplicity in one area where the other exhibits simplicity in another and it all roughly balances out. Humans seem to demand approximately a constant level of complexity from their languages. English for example has pretty complicated consonant clusters (e.g. hurdle, or angsts) to make up for fewer syllables. I'm not even sure English tends to have fewer syllables than French, as their common Celtic roots seem to prefer fewer syllables.

johnchristopher2• 11 years ago

But in practice, what twisted collective mind could come up and stay with "Qu'est ce que c'est ?" (What is it ?) ? That monster literally translate to "What is this that it is ?".

The same one who came up with "Au jour d'aujourd'hui". And "sociétal" in place of "social". The usage of any given language is bound to evolve over time into such... monsters.

Sarcasm apart, french is indeed a difficult language to learn (as a native and as foreigner) according to my PhD linguist friend but the movie english, the book english and the internet english is a poor subset of english. It's a simple english like the basic english everyone speak around the world.

grondilu2• 11 years ago

"Qu'est ce que c'est ?"

To be fair in French you rarely say that. You'd say "c'est quoi ça?". I know, it's not the same register but it just shows that people naturally shape their language to its most efficient form.

vmarsy• 11 years ago

English seems more appropriate than French in some domains, but when it comes to social communication, I prefer French.

The lack of masculine/feminine, and the "you" that either represent one or multiple persons[1] makes communication, especially texting, more ambiguous than in French.

When you want to avoid all ambiguity your message will be longer than the French one, and you will also probably look awkward.

[1]Some regional languages have a fix for this such as "y'all" but not everywhere.

ranit• 11 years ago

From the article:

> ... bilinguals - defined in the study as those who spoke two or more languages

So, perhaps not speaking, or not be able to speak second language does exclude you.

shas3• 11 years ago

Further, do programming languages and math (each with their own definitions, notations, and axioms) count as language? I guess that would depend on how the brain processes these vs. spoken/written language.

How about dialects and very closely related languages? Surely, say, Tamil (or Mandarin) and English are quite different or orthogonal even, while Tamil (or Mandarin) and Kannada (or Cantonese) have similarities having diverged more recently (~2000 years for Tamil and Kannada/~1000 years for Chinese).

auvrw• 11 years ago

programming languages and math

i'm guessing these as much parietal as frontal. although we describe them as languages, they are indeed "processed" in a different way than verbal fluency.

ionforce• 11 years ago

As far as I know (amateur language learning enthusiast) there's no support linking programming languages to foreign languages, other than random Internet folk such as ourselves drawing upon superficial similarities.

AdmiralAsshat• 11 years ago

Strictly anecdotal, but I'll mention it anyway:

My grandfather was bilingual, but his native tongue was Arabic. He held off dementia until his 90's, but when it finally set in, it hit hard. It got to the point where he often gave up trying to speak because he couldn't finish the sentence without forgetting a word he wanted and getting frustrated.

Surprisingly, however, he often remembered the word in English and started speaking that instead. To use a computer analogy, it is as though the sector of his brain where the Arabic was stored had become corrupted, while the English sector was still readable.

theviajerock• 11 years ago

Very interesting anecdote.

RobertoG• 11 years ago

The same happens with my grandmother but the other way around. She doesn't speak her second language anymore, she has returned to the one of her childhood, but it seems like she understand it yet.

dahart• 11 years ago

It looks like there are multiple referenced sources of bilingualism contributing to "cognitive reserve". Pretty cool if there are direct tangible health benefits to learning!

But twice as likely is a very big number in this context. It sounds like the population sample was all from Hyderabad, not a global sample. Is it possible environmental factors are present? Or perhaps socioeconomic factors -- I'd speculate that bilingual people are probably on average wealthier, leading to a wide range of possible benefits, including healthier diet, and better living conditions and location. I know it's armchair critique, but I just can't help but be a little skeptical of this headline.

Choronzon• 11 years ago

"even after taking into account other factors such as smoking, high blood pressure, diabetes and age" But not IQ and social status,bilingual people are more likely to score higher on both and this could be an aspect of healthier cognitive functions rather than how many languages you know.

madaxe_again• 11 years ago

Came here to say the same. Correlation is not indicative of causation. Bilingual people are more likely to be more upwardly mobile, and therefore likely have access to better care. Neurology probably has nothing to do with it.

djhn• 11 years ago

My gut reaction would be to control for wealth or income, which they do not.

I am not very familiar with Indian demographics, but I would assume monolingual people represent the poorest of the population?

zxexz• 11 years ago

I've only been to India once, so obviously anything I say should be treated as purely anecdotal. In rural Karnataka, I did notice, that although literacy rates (writing/reading) weren't nearly as high among the poorest population, it seemed to be the norm that they knew Kannada along with at least one of Konkani, Tamil, Urdu and/or another local language. English was also very common, but not among the poorest.

usrusr• 11 years ago

My gut reaction: "metric used to measure stroke recovery favors bilinguals"

The article mentions cognitive tasks that are likely to benefit on some level from "thinking in language". Duo clearly unrelated tasks like motor control also correlate? Is this really about brain activity keeping the system "fresh" and more capable of repair, or is it maybe just a simple matter of someone with "more words" pre-stroke having "more words" post-stroke?

My wildly uneducated guess, illustrated with computer analogies: when the brain has to cope with multiple languages, "language thinking" overflows from dedicated to general purpose "hardware" and due to some evolutionary dice roll, the dedicated stuff tends to get taken out first in a stroke.

sunwooz2• 11 years ago

A lot of people in India speak both English and Hindi, plus a host of other regional languages.

"even after taking into account other factors such as smoking, high blood pressure, diabetes and age"

Did they take into account that people who speak multiple languages are potentially more financially secure and thus would have a healthier/more nutritional diet/lifestyle?

sremani• 11 years ago

In Hyderabad, people even with little education tend to converse in Telugu and Urdu/Hindi to a level a fluency. Ability to speak English is reflection of better social or economic status. You can still find a lot of people who speak two languages and who are not well off in HYD.

sunwooz2• 11 years ago

It just seems like a contentious area to test this on. America would be better considering many people are monolingual.

VikingCoder• 11 years ago

Si. Es muy bueno.

swsieber• 11 years ago

If you want a lot more information about stroke and linguistics, I highly recommend the book "One Hundred Names for Love: A Memoir" It's about an older married couple, both wordsmiths by trades (linguistics professors? I can't remember). The husband has a stroke leaving him with a single word vocabulary.

It documents what they did in his recovery process as well as mentions the various types of language impairments that can come with stroke. It's a great book - touching and educational.

IIRC, the book mentions that strokes affect single native language, dual native languages, and post childhood acquired languages differently. And that if you want to be able to communicate after a stroke you best bet is to learn another language. Though it's been several years since I've read the book.

Bilingual people are twice as likely to recover from a stroke, study finds

Related Stories