Language disintegration: communication ability in elderly immigrants with dementia
Authors: Ursula S Goth, Benedicte S Strøm
Journal: The Lancet Public Health (2018)

About 46·8 million people worldwide are estimated to have dementia and this number will almost double every 20 years.1Prince MI Wimo A Guerchet MM Ali GC Wu YT Prina M World Alzheimer Report 2015, The Global Impact of Dementia: an analysis of prevalence, incidence, cost and trends. Alzheimer's Disease International, London2015https://www.alz.co.uk/research/world-report-2015Date accessed: September 14, 2018Google Scholar Most countries have an ageing population with an increasing number of immigrants, and many of these elderly immigrants will develop dementia in a country other than that of their origin. In various dementia disorders language deficits have increased, especially at a later stage of dementia,2Engedal K Haugen PK Brækhus A Demens: fakta og utfordringer, en lærebok. Aldring og helse, Tønsberg2009Google Scholar often shown by difficulties with word-finding (anomia). Individuals with anomia struggle to use the correct words.2Engedal K Haugen PK Brækhus A Demens: fakta og utfordringer, en lærebok. Aldring og helse, Tønsberg2009Google Scholar Thus far, insufficient attention has been given to the assessment of communicative abilities in people with dementia.3Strøm BS Ytrehus S Grov E-K Sensory stimulation for persons with dementia: a review of the literature.J Clin Nurs. 2016; 25: 1805-1834Crossref PubMed Scopus (64) Google Scholar Loss of language might precede other aspects of cognitive decline2Engedal K Haugen PK Brækhus A Demens: fakta og utfordringer, en lærebok. Aldring og helse, Tønsberg2009Google Scholar and could be an early indicator for development of cognitive decline or dementia.4McMurtray A Saito E Nakamoto B Language preference and development of dementia among bilingual individuals.Hawaii Med J. 2009; 68: 223-226PubMed Google Scholar Language loss is often asymmetrical, with preferential preservation and use of the first-acquired language (ie, language reversion).5Pearce JM A note on aphasia in bilingual patients: Pitres' and Ribot's laws.Eur Neurol. 2005; 54: 127-131Crossref PubMed Scopus (25) Google Scholar Maintenance of proficiency in multiple languages requires increased cognitive demands compared with a single language. Consequently, non-primary languages appear particularly vulnerable to the effects of cognitive decline.4McMurtray A Saito E Nakamoto B Language preference and development of dementia among bilingual individuals.Hawaii Med J. 2009; 68: 223-226PubMed Google Scholar Caring for elderly migrants with language loss can therefore be a challenge for health-care providers. Language reversion often occurs in immigrants with dementia because pathological processes cause reversion to the native language.4McMurtray A Saito E Nakamoto B Language preference and development of dementia among bilingual individuals.Hawaii Med J. 2009; 68: 223-226PubMed Google Scholar, 5Pearce JM A note on aphasia in bilingual patients: Pitres' and Ribot's laws.Eur Neurol. 2005; 54: 127-131Crossref PubMed Scopus (25) Google Scholar Culturally and linguistically diverse elderly people with dementia face many unique challenges and needs6Tipping SA Whiteside M Language reversion among people with dementia from culturally and linguistically diverse backgrounds: the family experience.Aust Soc Work. 2015; 68: 184-197Crossref Scopus (14) Google Scholar because of impairment of verbal and non-verbal language, which worsens with the degenerative process of dementia.2Engedal K Haugen PK Brækhus A Demens: fakta og utfordringer, en lærebok. Aldring og helse, Tønsberg2009Google Scholar Bilingual people with dementia also tend to mix languages and have problems with language separation.7Mendez MF Cummings JL Dementia: a clinical approach. Butterworth-Heinemann, Oxford2003Google Scholar Communication is essential for social life, regardless of cognitive function, and for avoiding isolation, strengthening patients' identity, and decreasing depression and anxiety.8Lubinski R Dementia and communication. Singular Publishing Group, Norwich1995Google Scholar With a growing ageing population and increased global migration, language reversion is an upcoming and challenging topic that has received little research attention. Assessment of elderly immigrants is necessary for adapting health-care services and interventions. Dissemination of accumulated knowledge from studies about elderly migrants and language is urgently needed. We declare no competing interests.