Comparative effects of education and bilingualism on the onset of mild cognitive impairment

Subasree Ramakrishnan, Shailaja Mekala, Annapurna Mamidipudi, Sireesha Yareeda, Rukmini Mridula, Thomas H. Bak, Suvarna Alladi*, Subhash Kaul

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Increasing evidence suggests that life course factors such as education and bilingualism may have a protective role against dementia due to Alzheimer disease. This study aimed to compare the effects of education and bilingualism on the onset of cognitive decline at the stage of mild cognitive impairment (MCI). Methods: A total of 115 patients with MCI evaluated in a specialty memory clinic in Hyderabad, India, formed the cohort. MCI was diagnosed according to Petersen's criteria following clinical evaluation and brain imaging. Age at onset of MCI was compared between bilinguals and monolinguals, and across subjects with high and low levels of education, adjusting for possible confounding variables. Results: The bilingual MCI patients were found to have a clinical onset of cognitive complaints 7.4 years later than monolinguals (65.2 vs. 58.1 years; p = 0.004), while years of education was not associated with delayed onset (1-10 years of education, 59.1 years; 11-15 years of education, 62.6 years; >15 years of education, 62.2 years; p = 0.426). Conclusion: The effect of bilingualism is protective against cognitive decline, and lies along a continuum from normal to pathological states. In comparison, the role of years of education is less robust.

Original languageEnglish
Pages (from-to)222-231
Number of pages10
JournalDementia and Geriatric Cognitive Disorders
Issue number3-4
Early online date28 Sep 2017
Publication statusPublished - Nov 2017


  • cognitive reserve
  • dementia
  • language
  • mild cognitive impairment


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