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

项目摘要/摘要 整个社会正面临着一种全球性的“痴呆症流行病”，预计这种流行病将随着老龄化的加剧而加剧。 人口。尽管目前还没有治愈这种毁灭性的普遍疾病的方法，但有一种生活经历 双语是预防阿尔茨海默病和相关疾病(ADRD)的有效方法。 然而，关于双语能力是认知储备的一个因素的研究结果好坏参半。这些混合在一起 研究结果可能部分归因于不同文化背景下的双语体验特征的差异性 除了存在潜在的混杂变量外，还有社会文化背景。几乎没有人注意到 旨在审查双语因素(例如，语言优势、熟练程度、使用情况和年龄 收购)，这可能会低估这些发现。此外，人们对语言的关注也有限-- 突出的痴呆症，如原发性进行性失语(PPA)。虽然言语和语言 损害是ADRD的普遍特征，在PPA的情况下，这些衰弱的缺陷表现为初始， 主要症状。在双语的PPA中观察到了不同的语言下降模式， 文献中报道的第一次学习语言的弹性和平行下降。然而，一种微妙的描述 建立跨不同语言领域的语言衰退模式还没有系统化 在PPA中进行了检查。此外，尽管言语干预的积极效果现在很好 在单语说话者中记录的PPA，在文献检查治疗中有显著的差距 通过PPA为双语扬声器进行了优化。此外，行为、神经和双语因素与 在有PPA的双语使用者中，语言重新学习尚未建立。建议的总体目标是 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，有PPA的双语者(西班牙语-加泰罗尼亚语)。在目标1中，我们试图找出与双语相关的因素 每种PPA变种的西班牙裔患者的发病年龄较晚。在目标2中，我们试图找出双语因素 与西班牙裔语言障碍的不同模式相关的PPA使用源自 连通的演讲。在目标3中，我们将最大限度地评估量身定制的言语干预的好处 迄今为止，PPA对双语拉美裔人的行为康复研究。我们还将确定双语能力 与双语有关的因素、治疗前的认知-语言测量和大脑区域可以预测 语言内部收益的大小和跨语言迁移的影响。为了实现这些目标，我们 将招收90名具有PPA的西班牙裔双语者，他们将接受行为评估、核磁共振成像和语音语言 治疗。该提案将通过以下方式提供关于认知储备和语言弹性的必要证据 通过既定的国际合作，利用大量的双语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 影响语言突出痴呆患者认知储备和语言韧性的因素。

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.