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Clinical Manifestations.

Muskaan Sandhu1, Jeanine Sandra Estaban1, Janhavi Pillai2

  • 1University of California, San Francisco, San Francisco, CA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

Bilingualism impacts cognitive performance differently across frontotemporal dementia variants. Language-focused Primary Progressive Aphasia (PPA) patients showed improved language skills, while non-language-focused Behavioral Variant Frontotemporal Dementia (bvFTD) patients had lower memory and visuospatial scores.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Linguistics

Background:

  • Conflicting evidence exists on bilingualism's role as a cognitive reserve protective factor.
  • Behavioral Variant Frontotemporal Dementia (bvFTD) and Primary Progressive Aphasia (PPA) affect distinct neural networks.
  • The influence of bilingualism on these specific FTD networks remains unclear.

Purpose of the Study:

  • To investigate if the cognitive impact of language-related FTD (PPAs) versus non-language-related FTD (bvFTD) differs between monolingual and bilingual individuals.
  • To explore the interaction between bilingual status and specific FTD variants on cognitive performance.

Main Methods:

  • Analyzed a cohort of 316 patients (224 monolingual, 92 bilingual) with four FTD variants: lvPPA, svPPA, nfvPPA, and bvFTD.
  • Assessed cognitive performance across 26 neuropsychological tasks (general cognition, language, visuospatial, memory, executive function).
  • Utilized multivariate linear regression with an interaction term for bilingual status and disease variant, controlling for age, education, and gender.

Main Results:

  • Bilingual patients with bvFTD performed significantly worse on memory and visuospatial tasks compared to monolingual bvFTD patients.
  • Bilingual patients with Semantic Variant Primary Progressive Aphasia (svPPA) demonstrated enhanced performance on language tasks compared to monolingual svPPA patients.

Conclusions:

  • Bilingualism's effect on cognitive function varies depending on the specific frontotemporal dementia variant.
  • These findings underscore the nuanced role of bilingualism in cognitive reserve and the importance of variant-specific analysis.
  • Future research should examine the longitudinal cognitive trajectories of bilingual individuals with FTD compared to monolinguals.