Bibliographic reference
Nijmeijer SE, van Tol MJ, Aleman A, Keijzer M – Foreign Language Learning as Cognitive Training to Prevent Old Age Disorders? Protocol of a Randomized Controlled Trial of Language Training vs. Musical Training and Social Interaction in Elderly With Subjective Cognitive Decline – Front Aging Neurosci. 2021 Apr 27;13:550180. doi: 10.3389/fnagi.2021.550180. PMID: 33986653; PMCID: PMC8111015.
At a glance
The first randomized control trial to investigate the effects of learning a new language on cognition, linguistic proficiency, socio-affective measures and brain activity in the elderly is currently underway. If successful, this study might provide insights into how foreign language training may help prevent cognitive and mental decline in later life.
The context
Aging leads to a general reduction of cognitive reserve in terms of flexibility and cognitive control. This reduction is linked, in turn, with the development of depression and cognitive decline that can occur in later life. Many factors have been investigated as ways to mitigate the reduction of cognitive reserve, such as education, exercise, and stimulating leisure activities. Another factor is receiving much attention as an aid in strengthening cognitive reserve: knowledge of a second language. Knowledge of two or more languages could potentially create semantic competition between the two languages and, due to the need to manage this conflict, strengthen cognitive control in the individual. Cognitive flexibility might also be strengthened, due to the need to switch between different mental sets.
Given the lack of clear conclusions about the actual occurrence and manner of these effects, newer studies agree on the need for more comprehensive and better designed studies. These studies should, in one design, investigate improvements in linguistic competence, socio-affective measures, cognitive effects, and brain changes induced in the elderly by learning a new language.
The characteristics of the study
A protocol was devised and is currently being used with 198 participants, aged 65 to 85 years, who report subjective cognitive decline. The participants are being randomly assigning to a language intervention, a musical intervention chosen as a cognitive control, or a social intervention used as a social control. Over a period of 3 to 6 months, the language group is being taught English, the music group is being taught to play guitar, and the social group is involved in art workshops. The art workshops do not require a commitment comparable to the other interventions. In order to estimate the cognitive flexibility and mental health of the participants, various parameters such as clinical, cognitive, and brain activity of the involved areas are being assessed. Assessment is carried out through test batteries and the combination of EEG and neuroimaging (fNIRS technique) administered at the beginning of the rehabilitation programs and in two subsequent follow-ups, respectively at 3 and 6 months from the start.
The results
This protocol was primarily designed and created to assess whether learning a new language is capable of improving the cognitive flexibility of older persons, with subjective cognitive decline, in a way that is significant and different from other types of interventions. In the submitted protocol, the use of behavioral test batteries is complemented with neuroimaging and electroencephalography methods.
Secondly, the protocol has the ability to highlight the effects of linguistic training on patient mental health along dimensions such as: emotion regulation, depressive state, apathy, rumination, and loneliness.
Due to the intensity of the language learning effort, and large number of participants involved in the first study to apply this protocol, these parameters can also prospectively be assessed by measuring the relationship between training intensity and patient response.
If these efforts are successful, the clinical implications will be important. They would indicate that it is possible to reduce the risk of cognitive disorders and depression in the elderly by learning a new language.
Study limitations
The study protocol is probably not free of systematic errors due to the sampling of participants. First, individuals selected to receive language or music training are more likely to have a lower level of education than a higher one. This is because individuals with a higher level of education are more likely to already speak English or know how to play an instrument. In addition, the eligible seniors who actually decide to undergo cognitive training are likely to be more motivated and active than those who choose not to participate. Other limitations include the duration of the teaching programs – which increases the risk of drop-outs – and the level of computer literacy required to receive part of the lessons – usually a weak point for older people.
What’s new
The protocol devised for this study is the first to investigate the effects of linguistic training on cognitive reserve by comparing it with other cognitively or socially stimulating activities. Earlier approaches compared bilingual people with others who knew only one language.
In addition, for the first time, this protocol involves the combination of a wide range of measures regarding patient cognitive function and mental health.
