Cognitive and brain reserve in bilingual speakers with clinical AD variants
- 1Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences University of California, San Francisco San Francisco California USA
- 2Department of Speech, Language, and Hearing Sciences University of Texas Austin Texas USA
- 3Department of Psychology University of California Berkeley California USA
Abstract
INTRODUCTION: Bilingualism may confer resilience through enhanced neural integrity. However, evidence for its neuroprotective effect is mixed, and studies across Alzheimer's disease (AD) variants are limited. This study examined gray matter volume (GMV) differences between bilinguals and monolinguals with amnestic AD and logopenic variant primary progressive aphasia (lvPPA).
METHODS: In 125 amnestic AD and 78 lvPPA participants with neuropsychological assessments and structural magnetic resonance imaging, we analyzed GMV differences between monolinguals and bilinguals within each variant, adjusting for demographic covariates.
RESULTS: In amnestic AD, bilinguals showed lower GMV than monolinguals in several regions, including bilateral fusiform and right occipital regions, after correction for multiple comparisons. In lvPPA, regional differences did not survive correction for multiple comparisons, although at the nominal threshold, bilinguals showed lower GMV in temporal and occipital regions and greater GMV in inferior parietal regions. Cognitive performance was comparable between monolinguals and bilinguals within each group.
DISCUSSION: Comparable cognitive performance despite lower GMV is consistent with a potential role of bilingualism in cognitive reserve. The observed regional patterns in lvPPA are exploratory and require replication in a larger sample.
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BibTeX
@article{biondo2026cognitive,
title = {{Cognitive and brain reserve in bilingual speakers with clinical AD variants}},
author = {Nicoletta Biondo and John Matthew Suntay and Maria Luisa Mandelli and Muskaan Sandhu and Jeanine Sandra Estaban and Janhavi Pillai and Eugenie Mamuyac and Rochelle‐Jan Reyes and Ariel Guevarra and Maya L. Henry and Nina F. Dronkers and Maria Luisa Gorno‐Tempini and Stephanie M. Grasso and Jessica de Leon},
journal = {Alzheimer's \& Dementia : Diagnosis, Assessment \& Disease Monitoring},
year = {2026},
month = nov,
doi = {10.1002/dad2.70506},
url = {https://doi.org/10.1002/dad2.70506},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Cognitive and brain reserve in bilingual speakers with clinical AD variants
AU - Nicoletta Biondo
AU - John Matthew Suntay
AU - Maria Luisa Mandelli
AU - Muskaan Sandhu
AU - Jeanine Sandra Estaban
AU - Janhavi Pillai
AU - Eugenie Mamuyac
AU - Rochelle‐Jan Reyes
AU - Ariel Guevarra
AU - Maya L. Henry
AU - Nina F. Dronkers
AU - Maria Luisa Gorno‐Tempini
AU - Stephanie M. Grasso
AU - Jessica de Leon
PY - 2026
DA - 2026/11/02
JO - Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring
DO - 10.1002/dad2.70506
UR - https://doi.org/10.1002/dad2.70506
AB - INTRODUCTION: Bilingualism may confer resilience through enhanced neural integrity. However, evidence for its neuroprotective effect is mixed, and studies across Alzheimer's disease (AD) variants are limited. This study examined gray matter volume (GMV) differences between bilinguals and monolinguals with amnestic AD and logopenic variant primary progressive aphasia (lvPPA). METHODS: In 125 amnestic AD and 78 lvPPA participants with neuropsychological assessments and structural magnetic resonance imaging, we analyzed GMV differences between monolinguals and bilinguals within each variant, adjusting for demographic covariates. RESULTS: In amnestic AD, bilinguals showed lower GMV than monolinguals in several regions, including bilateral fusiform and right occipital regions, after correction for multiple comparisons. In lvPPA, regional differences did not survive correction for multiple comparisons, although at the nominal threshold, bilinguals showed lower GMV in temporal and occipital regions and greater GMV in inferior parietal regions. Cognitive performance was comparable between monolinguals and bilinguals within each group. DISCUSSION: Comparable cognitive performance despite lower GMV is consistent with a potential role of bilingualism in cognitive reserve. The observed regional patterns in lvPPA are exploratory and require replication in a larger sample.
SN - 2352-8729
ER -