Bilingual Factors Associated with Cognitive Reserve and Linguistic Resilience in Hispanics with Primary Progressive Aphasia

与原发性进行性失语症西班牙裔认知储备和语言弹性相关的双语因素

• 批准号: 10584281
• 负责人: Stephanie M Grasso
• 金额: $ 69.36万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-01 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10584281
• 关键词: Address; Aftercare; Age; Age of Onset; Alzheimer' s disease related dementia; Aphasia; Attention; Behavior; Behavior Therapy; Behavior assessment; Behavioral; Brain; Brain region; Characteristics; Cognitive; Collaborations; Communication; Confounding Factors (Epidemiology); Dementia; Enrollment; Epidemic; Evidence based treatment; Goals; Hispanic; Hispanic Populations; Individual; International; Intervention; Knowledge; Language; Language Development; Language Tests; Learning; Life Experience; Linguistics; Literature; Long-Term Effects; Magnetic Resonance Imaging; Maintenance; Measures; Names; Nature; Nerve Degeneration; Neurobiology; Outcome; Participant; Pattern; Performance; Predictive Factor; Primary Progressive Aphasia; Production; Proxy; Public Health; Rehabilitation therapy; Reporting; Research; Semantics; Site; Societies; Speech; Symptoms; Syndrome; Training; Treatment outcome; Underserved Population; Variant; aging population; behavior prediction; bilingualism; clinical phenotype; clinical practice; cognitive reserve; cohort; design; experience; improved; language impairment; lexical; lexical retrieval; neural; neurodegenerative phenotype; neuromechanism; predicting response; resilience; social culture; stem; theories; therapy design; treatment optimization; treatment research; treatment response

Project Summary/Abstract Society at large is facing a global “dementia epidemic” that is predicted to intensify with the growing aging population. Although there is currently no cure for this devastating and pervasive condition, one life experience shown to protect against the onset of Alzheimer’s disease and related disorders (ADRD) is that of bilingualism. Nevertheless, findings regarding bilingualism as a contributor to cognitive reserve are mixed. These mixed findings may, in part, be attributed to variability in the characterization of the bilingual experience across distinct sociocultural contexts in addition to the presence of potential confounding variables. Little attention has been directed towards examining bilingualism factors (e.g., language dominance, proficiency, use and age of acquisition) that may underly these findings. In addition, limited attention has been directed towards language- prominent dementia syndromes, such as primary progressive aphasia (PPA). Although speech and language impairments are ubiquitous features of ADRD, in the case PPA these debilitating deficits manifest as initial, predominant symptoms. Differential patterns of language decline have been observed in bilingual PPA, with resilience of the first learned language and parallel decline reported in the literature. However, a nuanced account establishing patterns of language decline across different linguistic domains has yet to be systematically examined in PPA. In addition, although positive effects of speech-language intervention are now well documented in monolingual speakers with PPA, there is a significant gap in the literature examining treatment optimized for bilingual speakers with PPA. Moreover, the behavioral, neural and bilingual factors associated with language re-learning have yet to be established in bilingual speakers with PPA. The overall aim of the proposed research is to establish associations between bilingualism factors and the onset, decline, and treatment response of Hispanic, bilinguals (Spanish-Catalan) with PPA. In Aim 1, we seek to identify bilingualism factors associated with a later age of onset in Hispanics with each PPA variant. In Aim 2, we seek to identify the bilingualism factors associated with differential patterns of language impairment in Hispanics with PPA using metrics derived from connected speech. In Aim 3, we will evaluate the benefits of tailored speech-language intervention in the largest behavioral rehabilitation study of bilingual Hispanics with PPA to-date. We will also identify the bilingualism factors, pre-treatment cognitive-linguistic measures, and brain regions implicated in bilingualism that predict the magnitude of within-language gains and cross-language transfer effects. In order to accomplish these aims, we will enroll 90 Hispanic, bilinguals with PPA who will undergo behavioral assessment, MRI, and speech-language treatment. This proposal will provide needed evidence regarding cognitive reserve and linguistic resilience by leveraging a large bilingual PPA cohort via an established international collaboration. Outcomes will also provide crucial knowledge regarding neural mechanisms of language re-learning and will address how specific bilingual factors influence cognitive reserve and linguistic resilience in language-prominent dementia.

项目总结/摘要 整个社会正面临着一场全球性的“痴呆症流行病”，预计随着老龄化的加剧， 人口虽然目前还没有治愈这种破坏性和普遍的条件，一个生活经验， 双语能力是预防阿尔茨海默氏病及相关疾病（ADRD）发作的一个重要因素。 然而，双语作为认知储备的贡献者的研究结果是喜忧参半的。这些混合 研究结果可能在一定程度上归因于不同地区双语体验特征的差异性。 社会文化背景以及潜在的混杂变量。很少注意 旨在检查双语因素（例如，语言优势，熟练程度，使用和年龄 这可能是这些发现的基础。此外，对语言的关注有限- 突出的痴呆综合征，如原发性进行性失语症（PPA）。虽然言语和语言 损伤是ADRD的普遍特征，在PPA的情况下，这些使人衰弱的缺陷表现为初始， 主要症状在双语PPA中观察到了不同的语言衰退模式， 第一次学习语言的弹性和文献中报道的平行下降。然而，一个微妙的帐户， 在不同的语言领域建立语言衰退的模式还有待系统地 检查PPA。此外，虽然言语-语言干预的积极效果现在很好， 在PPA单语者中的记录，在研究治疗的文献中有一个显着的差距 为使用PPA的双语人士优化。此外，行为，神经和双语因素与 语言再学习还有待于在患有PPA的双语者中建立。建议的总体目标 研究旨在建立双语因素与发病、衰退和治疗反应之间的联系 西班牙裔，双语（西班牙语-加泰罗尼亚语）与PPA。在目标1中，我们试图找出与双语相关的因素， 在西班牙裔患者中，每种PPA变体的发病年龄较晚。在目标2中，我们试图确定双语因素 与西班牙裔PPA患者语言障碍的差异模式相关，使用的指标来自 连接的演讲在目标3中，我们将评估最大规模的定制语音语言干预的好处。 迄今为止，对患有PPA的双语西班牙裔人的行为康复研究。我们还将确定双语 因素，治疗前认知语言测量，以及与双语有关的大脑区域，这些因素可以预测 语言内增益和跨语言迁移效应的大小。为了实现这些目标，我们 将招募90名西班牙裔双语PPA患者，他们将接受行为评估，MRI和语言 治疗这一建议将提供必要的证据，认知储备和语言弹性， 通过已建立的国际合作，利用大型双语PPA队列。成果还将提供 关于语言再学习的神经机制的关键知识，并将解决如何具体的双语 影响语言突出型痴呆患者认知储备和语言恢复力的因素