title: Impact of Bilingualism on Cognitive Outcome After Stroke.
abstract: OBJECTIVE
  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.
authors.affiliation: From the Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India (S.A., S.M., A.R., R.K., S.K.); Department of Psychology, Centre for Clinical Brain Sciences and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom (T.H.B.); Department of Neurology, Yashoda Hospitals, Hyderabad, India (J.R.C.); Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (E.M.); Cognitive Science Laboratory, IIIT, Hyderabad, India (B.S.); and Department of Linguistics, Osmania University, Hyderabad, India (V.D.). alladisuvarna@hotmail.com.
authors.forename: Suvarna
authors.initials: S
authors.lastname: Alladi
authors.affiliation: From the Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India (S.A., S.M., A.R., R.K., S.K.); Department of Psychology, Centre for Clinical Brain Sciences and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom (T.H.B.); Department of Neurology, Yashoda Hospitals, Hyderabad, India (J.R.C.); Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (E.M.); Cognitive Science Laboratory, IIIT, Hyderabad, India (B.S.); and Department of Linguistics, Osmania University, Hyderabad, India (V.D.).
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Bak
authors.affiliation: From the Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India (S.A., S.M., A.R., R.K., S.K.); Department of Psychology, Centre for Clinical Brain Sciences and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom (T.H.B.); Department of Neurology, Yashoda Hospitals, Hyderabad, India (J.R.C.); Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (E.M.); Cognitive Science Laboratory, IIIT, Hyderabad, India (B.S.); and Department of Linguistics, Osmania University, Hyderabad, India (V.D.).
authors.forename: Shailaja
authors.initials: S
authors.lastname: Mekala
authors.affiliation: From the Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India (S.A., S.M., A.R., R.K., S.K.); Department of Psychology, Centre for Clinical Brain Sciences and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom (T.H.B.); Department of Neurology, Yashoda Hospitals, Hyderabad, India (J.R.C.); Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (E.M.); Cognitive Science Laboratory, IIIT, Hyderabad, India (B.S.); and Department of Linguistics, Osmania University, Hyderabad, India (V.D.).
authors.forename: Amulya
authors.initials: A
authors.lastname: Rajan
authors.affiliation: From the Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India (S.A., S.M., A.R., R.K., S.K.); Department of Psychology, Centre for Clinical Brain Sciences and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom (T.H.B.); Department of Neurology, Yashoda Hospitals, Hyderabad, India (J.R.C.); Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (E.M.); Cognitive Science Laboratory, IIIT, Hyderabad, India (B.S.); and Department of Linguistics, Osmania University, Hyderabad, India (V.D.).
authors.forename: Jaydip Ray
authors.initials: JR
authors.lastname: Chaudhuri
authors.affiliation: From the Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India (S.A., S.M., A.R., R.K., S.K.); Department of Psychology, Centre for Clinical Brain Sciences and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom (T.H.B.); Department of Neurology, Yashoda Hospitals, Hyderabad, India (J.R.C.); Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (E.M.); Cognitive Science Laboratory, IIIT, Hyderabad, India (B.S.); and Department of Linguistics, Osmania University, Hyderabad, India (V.D.).
authors.forename: Eneida
authors.initials: E
authors.lastname: Mioshi
authors.affiliation: From the Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India (S.A., S.M., A.R., R.K., S.K.); Department of Psychology, Centre for Clinical Brain Sciences and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom (T.H.B.); Department of Neurology, Yashoda Hospitals, Hyderabad, India (J.R.C.); Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (E.M.); Cognitive Science Laboratory, IIIT, Hyderabad, India (B.S.); and Department of Linguistics, Osmania University, Hyderabad, India (V.D.).
authors.forename: Rajesh
authors.initials: R
authors.lastname: Krovvidi
authors.affiliation: From the Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India (S.A., S.M., A.R., R.K., S.K.); Department of Psychology, Centre for Clinical Brain Sciences and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom (T.H.B.); Department of Neurology, Yashoda Hospitals, Hyderabad, India (J.R.C.); Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (E.M.); Cognitive Science Laboratory, IIIT, Hyderabad, India (B.S.); and Department of Linguistics, Osmania University, Hyderabad, India (V.D.).
authors.forename: Bapiraju
authors.initials: B
authors.lastname: Surampudi
authors.affiliation: From the Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India (S.A., S.M., A.R., R.K., S.K.); Department of Psychology, Centre for Clinical Brain Sciences and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom (T.H.B.); Department of Neurology, Yashoda Hospitals, Hyderabad, India (J.R.C.); Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (E.M.); Cognitive Science Laboratory, IIIT, Hyderabad, India (B.S.); and Department of Linguistics, Osmania University, Hyderabad, India (V.D.).
authors.forename: Vasanta
authors.initials: V
authors.lastname: Duggirala
authors.affiliation: From the Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India (S.A., S.M., A.R., R.K., S.K.); Department of Psychology, Centre for Clinical Brain Sciences and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom (T.H.B.); Department of Neurology, Yashoda Hospitals, Hyderabad, India (J.R.C.); Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (E.M.); Cognitive Science Laboratory, IIIT, Hyderabad, India (B.S.); and Department of Linguistics, Osmania University, Hyderabad, India (V.D.).
authors.forename: Subhash
authors.initials: S
authors.lastname: Kaul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D058245:Cognitive Reserve; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019303:Multilingualism; D009483:Neuropsychological Tests; D012042:Registries; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*
keywords: aphasia; dementia, vascular; language; risk factors; stroke