Impact of Bilingualism on the Cognitive Outcomes in Stroke Survivors: A Systematic Review (P4-12.005)

Abstract

<h3>Objective:</h3> To examine existing evidence on the effect of bilingualism on cognitive outcomes in the stroke population. <h3>Background:</h3> Stroke is associated with an increased risk of vascular cognitive impairment. Bilingualism promotes cognitive reserve and resilience through the effect of language switching on the cognitive control systems and is suggested to delay cognitive impairment and dementia in non-stroke populations. However, the impact of bilingualism on cognitive outcomes in stroke patients has not been thoroughly examined. <h3>Design/Methods:</h3> We systematically reviewed published literature in medical databases that compared the cognitive assessment scores between mono-and bilingual stroke patients using cognitive assessment tool(s). We planned (1) a meta-analysis of outcome data using the subdomains of cognitive assessment tool(s); (2) a qualitative comparison if a meta-analysis was impossible. We assessed the study quality using the Joanna Briggs Institute tool. <h3>Results:</h3> Our literature search yielded 348 articles, and six were eligible for our systematic review (N=528 bilinguals; 737 monolinguals). One study was of good quality (Hope, 2015), and five were of moderate quality. We could not perform a meta-analysis because of disparate cohort characteristics and study methods, choice of cognitive tests, outcome measures, and lack of common data elements. Studies used one cognition and three language assessment batteries as cognitive assessment tools. In two studies, bilinguals performed better than monolinguals on cognitive tests (Paplikar, 2019; Alladi, 2016). On language assessment batteries, bilinguals performed better than monolinguals in four studies (Paplikar, 2019; Lahiri, 2020; Ardila, 2021; deLetter, 2021) and poorly in one study (Hope et al., 2015). ACE-R was significantly greater in bilinguals than monolinguals (Paplikar, 2019; Alladi, 2016). <h3>Conclusions:</h3> The current literature on the relationship between bilingualism and cognitive outcomes in stroke patients is sparse and insufficient. Harmonization of study methods (e.g., cognitive assessment tools) and common-data elements are critically needed to advance bilingualism research. <b>Disclosure:</b> Ms. Eldem has nothing to disclose. Mr. Misra has nothing to disclose. Dr. Quinn has nothing to disclose. Dr. Driskell has nothing to disclose. Dr. Perez has nothing to disclose. Dr. Carrión has nothing to disclose. Todd Constable has nothing to disclose. Dr. Schindler has received personal compensation for serving as an employee of Aeromics. Dr. Schindler has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for Aeromics. Dr. Schindler has received stock or an ownership interest from Aeromics. Dr. Schindler has received publishing royalties from a publication relating to health care. Dr. Zhao has nothing to disclose. Dr. Sico has nothing to disclose. Dr. Hinman has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Bertoldo, Baker, Carter &amp; Smith. Dr. Hinman has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Koskoff, Koskoff &amp; Bieder. Dr. Hinman has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Matthew Millea, PC. Dr. Hinman has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Popham Law Firm PC. Dr. Hinman has received stock or an ownership interest from Sage Cerebrovascular Diagnostics, Inc.. Dr. Hinman has received research support from NIH. Dr. Hinman has received research support from American Heart Association. Dr. Hinman has received research support from Reneuron. Dr. Hinman has received intellectual property interests from a discovery or technology relating to health care. Prof. Allore has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American College of Rheumatology. The institution of Prof. Allore has received research support from NIH. Prof. Allore has received personal compensation in the range of $500-$4,999 for serving as a DSMB member with NIH. An immediate family member of Prof. Kiran has received personal compensation for serving as an employee of Constant Therapy. Prof. Kiran has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Academy of Aphasia. Prof. Kiran has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Prof. Kiran has stock in Constant Therapy Health. The institution of Prof. Kiran has received research support from NIH. Jubin Abutalebi has nothing to disclose. Dr. Annoni has received personal compensation for serving as an employee of OMPharma, Switzerland . The institution of Dr. Annoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CERC European Cardiovascular Research Centre . Dr. Mishra has nothing to disclose.