Impact of Bilingualism on Cognitive Outcome After Stroke

Stroke. 2016 Jan;47(1):258-61. doi: 10.1161/STROKEAHA.115.010418. Epub 2015 Nov 19.


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.

Keywords: aphasia; dementia, vascular; language; risk factors; stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / epidemiology
  • Cognitive Dysfunction / psychology*
  • Cognitive Reserve*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multilingualism*
  • Neuropsychological Tests
  • Registries
  • Stroke / diagnosis*
  • Stroke / epidemiology
  • Stroke / psychology*