Language testing and the assessment of dementia in second language settings: a case study

Abstract

Procedures commonly used for assessing cognitive function in people with suspected dementia are of questionable validity in second language settings because of possible linguistic and cultural inappropriateness. This article reports a case study of a patient of Japanese background with suspected dementia in an English-speaking geriatric unit. The subject was thought to be able to understand and speak English sufficiently well for her daily activities, but was not engaging in communication with hospital staff. The case was further complicated by a history of schizophrenia. As part of a research project concerned with language disorder in speakers of English as a second language, the subject was tested using tasks selected on the basis of current knowledge regarding language decline and deficit in dementia of the Alzheimer type (DAT). The tasks, which the subject wished to do only in Japanese, included naming, story recall and processing by semantic category. The subject's performance in her first language did not, in general, indicate her language-processing abilities to be compromised by DAT. The results demonstrate the potential contribution of information from language-based tasks administered in the person's preferred language to screening for dementia in second language settings.