title: Early life instruction in foreign language and music and incidence of mild cognitive impairment.
abstract: OBJECTIVE
  To test the hypothesis that foreign language and music instruction in early life are associated with lower incidence of mild cognitive impairment (MCI) and slower rate of cognitive decline in old age.
  
  
  METHODS
  At enrollment in a longitudinal cohort study, 964 older persons without cognitive impairment estimated years of foreign language and music instruction by age 18. Annually thereafter they completed clinical evaluations that included cognitive testing and clinical classification of MCI.
  
  
  RESULTS
  There were 264 persons with no foreign language instruction, 576 with 1-4 years, and 124 with > 4 years; 346 persons with no music instruction, 360 with 1-4 years, and 258 with > 4 years. During a mean of 5.8 years of observation, 396 participants (41.1%) developed MCI. In a proportional hazards model adjusted for age, sex, and education, higher levels (> 4 years) of foreign language (hazard ratio [HR] = 0.687, 95% confidence interval [CI] [0.482, 0.961]) and music (HR = 0.708, 95% CI [0.539, 0.930]) instruction by the age of 18 were each associated with reduced risk of MCI. The association persisted after adjustment for other early life indicators of an enriched cognitive environment, and it was stronger for nonamnestic than amnestic MCI. Both foreign language and music instruction were associated with higher initial level of cognitive function, but neither instruction measure was associated with cognitive decline.
  
  
  CONCLUSIONS
  Higher levels of foreign language and music instruction during childhood and adolescence are associated in old age with lower risk of developing MCI but not with rate of cognitive decline.
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Wilson
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Boyle
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center.
authors.forename: Jingyun
authors.initials: J
authors.lastname: Yang
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center.
authors.forename: Bryan D
authors.initials: BD
authors.lastname: James
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center.
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007802:Language; D007858:Learning / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D019303:Multilingualism; D009146:Music
references.citation: Am J Epidemiol. 2009 Aug 1;170(3):331-42
references.pmid: 19605514
references.citation: Neuroimage. 2010 Jul 1;51(3):1234-41
references.pmid: 20346399
references.citation: Ann Neurol. 2011 Sep;70(3):418-26
references.pmid: 21425187
references.citation: Brain Res. 2012 Jul 17;1465:26-33
references.pmid: 22627162
references.citation: Front Psychol. 2013 Apr 30;4:222
references.pmid: 23641225
references.citation: Psychol Sci. 2011 Nov;22(11):1425-33
references.pmid: 21969312
references.citation: Int J Epidemiol. 2001 Apr;30(2):256-63
references.pmid: 11369724
references.citation: Neurology. 2010 Mar 23;74(12):951-5
references.pmid: 20308679
references.citation: Am J Epidemiol. 2003 Dec 1;158(11):1083-9
references.pmid: 14630604
references.citation: Psychol Aging. 2011 Mar;26(1):232-40
references.pmid: 20973608
references.citation: J Clin Exp Neuropsychol. 2003 Aug;25(5):634-42
references.pmid: 12815501
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: J Neurosci. 2013 Nov 6;33(45):17667-74
references.pmid: 24198359
references.citation: Lancet Neurol. 2006 Jan;5(1):87-96
references.pmid: 16361026
references.citation: J Int Neuropsychol Soc. 2005 Jul;11(4):400-7
references.pmid: 16209420
references.citation: Neurology. 2005 Mar 8;64(5):834-41
references.pmid: 15753419
references.citation: Psychol Aging. 2008 Mar;23(1):119-30
references.pmid: 18361661
references.citation: Neuropsychology. 2011 May;25(3):378-86
references.pmid: 21463047
references.citation: Front Hum Neurosci. 2012 Jul 19;6:198
references.pmid: 22833722
references.citation: Alzheimer Dis Assoc Disord. 2009 Oct-Dec;23(4):384-8
references.pmid: 19561439
references.citation: Arch Gen Psychiatry. 2007 Jul;64(7):802-8
references.pmid: 17606814
references.citation: Curr Alzheimer Res. 2012 Jul;9(6):646-63
references.pmid: 22471867
references.citation: Neurology. 2009 Feb 3;72(5):460-5
references.pmid: 19188578
references.citation: J Am Geriatr Soc. 2010 Oct;58(10):1903-10
references.pmid: 20840461
references.citation: Neurology. 2004 Nov 23;63(10):1882-91
references.pmid: 15557506
references.citation: Am J Epidemiol. 2009 Jul 15;170(2):244-56
references.pmid: 19494242
references.citation: Neurology. 2007 Nov 13;69(20):1911-20
references.pmid: 17596582
references.citation: J Neurosci. 2006 Jun 7;26(23):6314-7
references.pmid: 16763039
references.citation: Trends Cogn Sci. 2013 Oct;17(10):502-9
references.pmid: 24018144
references.citation: Int J Neurosci. 1991 Apr;57(3-4):167-78
references.pmid: 1938160
references.citation: Psychol Sci. 2013 Dec;24(12):2361-8
references.pmid: 24084038
references.citation: J Clin Exp Neuropsychol. 1991 Nov;13(6):933-49
references.pmid: 1779032
references.citation: Neuroepidemiology. 2005;25(1):8-14
references.pmid: 15855799
references.citation: Neurology. 2002 Jul 23;59(2):198-205
references.pmid: 12136057
references.citation: Neuropsychology. 2014 Mar;28(2):290-304
references.pmid: 24245925
references.citation: Arch Neurol. 2011 Mar;68(3):351-6
references.pmid: 21403020
references.citation: Neuroepidemiology. 2005;25(4):163-75
references.pmid: 16103727
references.citation: Brain. 1991 Oct;114 ( Pt 5):2095-122
references.pmid: 1933236
references.citation: Ann Neurol. 2008 Apr;63(4):494-506
references.pmid: 18300306
references.citation: Exp Aging Res. 2005 Oct-Dec;31(4):393-407
references.pmid: 16147459
references.citation: Arch Gen Psychiatry. 2008 Apr;65(4):439-45
references.pmid: 18391132
references.citation: Neurology. 2013 Jul 23;81(4):314-21
references.pmid: 23825173
references.citation: Arch Neurol. 2009 Jun;66(6):767-72
references.pmid: 19506138
references.citation: Neurology. 2006 Aug 8;67(3):441-5
references.pmid: 16894105
references.citation: Neurology. 1984 Jul;34(7):939-44
references.pmid: 6610841
references.citation: Neuroepidemiology. 2006;27(3):169-76
references.pmid: 17035694
references.citation: Psychol Aging. 2002 Jun;17(2):179-93
references.pmid: 12061405
references.citation: Neuroscientist. 2010 Apr;16(2):186-98
references.pmid: 19801372
references.citation: Stroke. 2003 May;34(5):1136-43
references.pmid: 12702832
references.citation: Psychol Sci. 2004 Aug;15(8):511-4
references.pmid: 15270994
references.citation: Neurology. 1994 Apr;44(4):609-14
references.pmid: 8164812
references.citation: J Gerontol B Psychol Sci Soc Sci. 2013 Jan;68(1):8-12
references.pmid: 22454387
references.citation: J Int Neuropsychol Soc. 2014 Feb;20(2):129-34
references.pmid: 24490866
references.citation: Neuron Glia Biol. 2004 Nov;1(4):351-63
references.pmid: 16921405
references.citation: Br J Psychiatry. 2003 May;182:449-54
references.pmid: 12724250
references.citation: Neurology. 2012 Jan 31;78(5):342-51
references.pmid: 22282647
references.citation: Neuropsychology. 2014 Mar;28(2):238-46
references.pmid: 24188113
references.citation: Psychol Aging. 2012 Dec;27(4):998-1007
references.pmid: 22612603
references.citation: Curr Biol. 2011 Dec 20;21(24):2109-14
references.pmid: 22169537
references.citation: Neurology. 2002 Nov 26;59(10):1594-9
references.pmid: 12451203
references.citation: J Neurosci. 2013 Jan 9;33(2):387-96
references.pmid: 23303919