It’s Not What You Say, But The Language You Say It In

Speaking more than one language can help you travel to exciting destinations, experience other cultures, and communicate with friends and colleagues around the world. But, speaking more than one language can also protect against cognitive impairment after stroke.

Each year, nearly 800,000 people in the United States experience stroke, which is a disruption in the flow of blood to the brain, either due to a hemorrhage (a burst blood vessel) or a clot that blocks blood flow through a vessel. If people survive a stroke, they may experience paralysis, speech, and language problems, behavior changes, and cognitive impairment such as memory loss.

A new study, published in the journal Stroke – a publication of the American Heart Association – reports that multilingual people experienced better outcomes after stroke than people who spoke only one language.

The authors evaluated data from 608 stroke patients from India who were part of a stroke registry. Approximately half of the patients were bilingual, which was defined as speaking at least two languages. The multi- and single-language groups were the same in terms of age and other risk factors for stroke outcomes. Outcomes were assessed using standard cognitive screening tools and dementia rating scales; the assessments were completed within 3 to 24 months of the stroke.

In this study, approximately 40% of bilingual patients had normal cognitive function after stroke, but only 20% of single-language patients had the same. Plus, bilingual patients had better memory and attention following stroke compared to their single-language counterparts. There was no difference in the rates of aphasia (a communication disorder characterized by difficulty reading, writing, and speaking)between bilingual and single-language groups.

In addition to benefiting stroke outcomes, bilingualism has been associated with delayed onset of cognitive decline in other studies. However, the actual benefits of speaking several languages is still debated owing to inconsistencies in study design and measurement of cognitive abilities. The findings of the current study, in particular, may not be widely applicable. People from the region in which the study was conducted speak as many as four languages and commonly switch among them during the day. Cognitive benefits of multilingualism may not be as pronounced in regions in which the need to function in more than one language is not as great.

While bilingualism helped patients fare better in this study, it is likely that any mentally challenging task could offer similar protective benefits for cognition. Switching languages requires executive function similar to playing a musical instrument or completing Sudoku puzzles. Any intellectually stimulating task that is pursued over time may be able to offer similar cognitive benefits and prevent impairment due to normal aging or stroke.


Alladi S, Bak TH, Mekala S, Rajan A, Chaudhuri JR, Mioshi E, Krovvidi R, Surampudi B, Duggirala V, & Kaul S (2015). Impact of Bilingualism on Cognitive Outcome After Stroke. Stroke; a journal of cerebral circulation PMID: 26585392

Hope TM, Parker Jones ‘, Grogan A, Crinion J, Rae J, Ruffle L, Leff AP, Seghier ML, Price CJ, & Green DW (2015). Comparing language outcomes in monolingual and bilingual stroke patients. Brain : a journal of neurology, 138 (Pt 4), 1070-83 PMID: 25688076

Perani D, & Abutalebi J (2015). Bilingualism, dementia, cognitive and neural reserve. Current opinion in neurology, 28 (6), 618-25 PMID: 26544028

von Bastian CC, Souza AS, & Gade M (2015). No Evidence for Bilingual Cognitive Advantages: A Test of Four Hypotheses. Journal of experimental psychology. General PMID: 26523426

Zahodne LB, Schofield PW, Farrell MT, Stern Y, & Manly JJ (2014). Bilingualism does not alter cognitive decline or dementia risk among Spanish-speaking immigrants. Neuropsychology, 28 (2), 238-46 PMID: 24188113

Image via oneinchpunch / Shutterstock.

Jennifer Gibson, PharmD

Jennifer Gibson, PharmD, is a practicing clinical pharmacist and medical writer/editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. She is the owner of Excalibur Scientific, LLC.
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