LANGUAGE IN INDIA

Bilingual Persons with Mild Dementia -
Spectrum of Cognitive Linguistic Functions

Deepa M.S., Ph.D. Candidate
Shyamala K. Chengappa, Ph.D.

Abstract

Cognitive linguistics (CL) refers to the school of linguistics that understands language creation, learning, and usage as best explained by reference to human cognition in general. With increase in age human cognition improves, which can be measured through tasks based on cognitive-linguistics. The tasks include attention and concentration, orientation, memory, organization etc. But these skills reduce their efficiency with advanced age. That is, younger population perform better as compared to older. And a disorder of elderly called dementia is a debilitating condition causing progressive deterioration in cognition, personality and communication skills. If healthy elderly perform less efficient in cognitive linguistic skills, then disordered population will perform still. Hence there is an immediate need to study the cognitive-linguistic performance in healthy elderly as compared to dementia.

The aim of the present study is to qualify the cognitive-linguistic performance in persons with dementia as compared to healthy elderly. Considered for the study were 20 (10 monolingual and 10 bilingual) healthy elderly and age matched persons with dementia. Monolingual persons had Kannada as their mother tongue/ first language and bilinguals had English as their second language. Cognitive linguistic Assessment Protocol (CLAP) (Kamath, 2001, Rajasudhakar, 2005) was administered for both the groups. The performance of healthy elderly as against to dementia is been discussed along with the performance of monolinguals versus bilinguals.

Key words: dementia, bilingualism, language, cognition.

Introduction

Communication is a manifestation of cognition. The linguistic representations for objects are part of long-term lexical memory and must be retrieved and brought to consciousness. Thus, the simple act of object naming requires perception, access to long term memory, association, recognition, lexical retrieval, decision-making, motor planning, and self-monitoring.

The cognitive-linguistic skills may be affected in people with closed head injury, cerebrovascular accidents and in cerebral neuropathogenesis. These deficits emerge as dynamic and pervasive, ranging from subtle to severe. Treatment of cognitive-linguistic deficits is a dynamic process that begins with assessment of patient's information processing skills, their ability for quantifying specific deficits and observation and recording of response behaviours (Ross-Swain, 1992).

Neurogenic communication disorders in adults encompass a variety of specific abnormalities all caused by nervous system pathology. These disorders include Aphasia, Right hemisphere damage, traumatic brain injury, dementia, dysarthria etc. Neurogenic communication disorders are an important consequence of nervous system abnormality. Their features, severity and outcome reflect the location, magnitude and nature of the abnormality. Aim of the present study is to primarily focus on Dementia and its effect.

Dementia

Dementia is the progressive decline in cognitive function due to damage or disease in the body beyond what might be expected from normal aging. Dementia is a non-specific illness syndrome (set of symptoms) in which affected areas of cognition may be memory, attention, language, and problem solving. According to American Psychiatric Association (2000), the clinical feature necessary for diagnosis of dementia are multiple deficits manifested by memory impairment and one or more of the cognitive disturbances such as aphasia, apraxia, agnosia or disturbance in executive functioning. Higher mental functions are affected first in the process. However in the later stages of the condition, affected persons may be disoriented in time (not knowing what day of the week, day of the month, or even what year it is), in place (not knowing where they are), and in person (not knowing who they are or others around them).

The early stage of dementia lasts from two to four years. The symptoms found during this stage include difficulty in handling finances, memory problems, concentration problems, difficulty with complex tasks, forgetting the location of objects and decreased awareness of recent events (Bayles, 1991). The first obvious symptom of dementia is a problem with episodic memory. Working memory also affected early in the progression of the disease, and is manifested by decreased efficiency of encoding and retrieval of information. Individuals have difficulty sustaining attention (Perry, Watson & Hodges, 2000; Backman, Small and Fratiglioni, 2001) and span memory is modestly attenuated in some individuals though not all.

Communicative Impairments in Dementia

Of growing interest to speech language pathologists and neuropsychologists is the communicative impairment present in individuals with dementia. A consensus exists that persons with mild to moderate dementia show relatively preserved phonologic, syntactic and lexical knowledge while semantic and pragmatic knowledge are markedly impaired (Appell, Kertesz & Fisman, 1982; Bayles, 1982; Emery & Emery, 1983; Murdoch, Chenery, Wilks & Boyle, 1987).

Communication abilities in bilingual demented patients and the pattern of language decline for first language(L1) and second language(L2) L1 and L2 in dementia are issues rarely mentioned in the dementia literature. It is a well known fact that, in persons with dementia, the ability to maintain fluency in more than one language decreases. It is well known, however, the ability to maintain fluency in more than one language decreases with aging (Hyltenstam & Obler, 1989). With advancing age, people may tend to retreat to a single language, regardless of a life-long history of bilingualism. Moreover, older bilinguals may experience increased difficulties handling two languages due to the effects of cross-language interference. These effects in aging bilingual persons can be further exacerbated in those who develop dementia.

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