Abstract
BackgroundLanguage impairment and behavioral symptoms are both common phenomena in dementia patients. In this study, we investigated the behavioral symptoms in dementia patients with different language backgrounds. Through this, we aimed to propose a possible connection between language and delusion.MethodsWe recruited 21 patients with Alzheimer’s disease (AD), according to the DSM-IV and NINCDS-ADRDA criteria, from the memory clinic of the Cardinal Tien Hospital in Taipei, Taiwan. They were classified into two groups: 11 multilinguals who could speak Japanese, Taiwanese and Mandarin Chinese, and 10 bilinguals who only spoke Taiwanese and Mandarin Chinese. There were no differences between age, education, disease duration, disease severity, environment and medical care between these two groups. Comprehensive neuropsychological examinations, including Clinical Dementia Rating (CDR), Mini-Mental Status Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), Verbal fluency, Chinese version of the Boston naming test (BNT) and the Behavioral Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD), were administered.ResultsThe multilingual group showed worse results on the Boston naming test. Other neuropsychological tests, including the MMSE, CASI and Verbal fluency, were not significantly different. More delusions were noted in the multilingual group. Three pairs of subjects were identified for further examination of their differences. These three cases presented the typical scenario of how language misunderstanding may cause delusions in multilingual dementia patients. Consequently, more emotion and distorted ideas may be induced in the multilinguals compared with the MMSE-matched controls.ConclusionInappropriate mixing of language or conflict between cognition and emotion may cause more delusions in these multilingual patients. This reminds us that delusion is not a pure biological outcome of brain degeneration. Although the cognitive performance was not significantly different between our groups, language may still affect their delusion.
Highlights
Language impairment and behavioral symptoms are both common phenomena in dementia patients
30–40% of patients suffer from some degree of behavioral symptoms during the stage of mild cognitive impairment (MCI) or mild dementia [1]
Post-mortem pathology has shown that Alzheimer’s disease (AD) patients with delusion exhibit more plaques and tangles in the frontal lobe [5]
Summary
Language impairment and behavioral symptoms are both common phenomena in dementia patients. We investigated the behavioral symptoms in dementia patients with different language backgrounds. We aimed to propose a possible connection between language and delusion. Editor: Dezhong Yao, University of Electronic Science and Technology of China, CHINA
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