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Background Increasing evidence shows that bilingualism or multilingualism may have beneficial effects on preventing dementia. We performed a cross-sectional, community-based study in Taiwan. Some elders (older than 70 years) in Taiwan can speak Japanese because of the formal Japanese education they received before World War II, when Taiwan was under Japanese rule. After the war, Mandarin Chinese was adopted as the official language of Taiwan. We assessed whether constantly using three languages had an effect on dementia prevalence and cognitive function. Methods We defined multilingualism as the ability to fluently speak Taiwanese (T), Japanese (J), and Mandarin Chinese (C) in daily life. We evaluated the Mini-Mental State Examination and AD8 questionnaire results of 514 community-dwelling people older than 70 years in Taishan, Taiwan. Results Seventy-three of the subjects (14.2%) were multilingual (T, J, C) and 441 (85.8%) were bilingual (T, C). No difference was noted in dementia prevalence between multilingual (6.8%) and bilingual (7.4%) populations, but multilinguals were older than bilinguals (mean age: 79.9 vs 77.3 years). Multilinguals had higher Mini-Mental State Examination scores than bilinguals (mean: 24.6 vs. 22.7). However, after the subjects were stratified into low and high education level groups, the Mini-Mental State Examination difference was found to be significant in only the low education level group. Conclusions Dementia prevalence did not significantly differ between the multilingual (T, J, C) and bilingual (T, C) groups. However, given that the average age of the multilingual group was approximately 2 years older than that of the bilingual group, there may have been minor effects in the multilingual group. [ABSTRACT FROM AUTHOR]

Background: Language impairment and behavioral symptoms are both common phenomena in dementia patients. In this study, we investigated the behavioral symptoms in dementia patients with different language backgrounds. Through this, we aimed to propose a possible connection between language and delusion. Methods: We recruited 21 patients with Alzheimer’s disease (AD), according to the DSM-IV and NINCDS-ADRDA criteria, from the memory clinic of the Cardinal Tien Hospital in Taipei, Taiwan. They were classified into two groups: 11 multilinguals who could speak Japanese, Taiwanese and Mandarin Chinese, and 10 bilinguals who only spoke Taiwanese and Mandarin Chinese. There were no differences between age, education, disease duration, disease severity, environment and medical care between these two groups. Comprehensive neuropsychological examinations, including Clinical Dementia Rating (CDR), Mini-Mental Status Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), Verbal fluency, Chinese version of the Boston naming test (BNT) and the Behavioral Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD), were administered. Results: The multilingual group showed worse results on the Boston naming test. Other neuropsychological tests, including the MMSE, CASI and Verbal fluency, were not significantly different. More delusions were noted in the multilingual group. Three pairs of subjects were identified for further examination of their differences. These three cases presented the typical scenario of how language misunderstanding may cause delusions in multilingual dementia patients. Consequently, more emotion and distorted ideas may be induced in the multilinguals compared with the MMSE-matched controls. Conclusion: Inappropriate mixing of language or conflict between cognition and emotion may cause more delusions in these multilingual patients. This reminds us that delusion is not a pure biological outcome of brain degeneration. Although the cognitive performance was not significantly different between our groups, language may still affect their delusion. [ABSTRACT FROM AUTHOR]

Background and Objectives Improving quality of life for community-dwelling older persons with dementia symptoms (PWDS) and family caregivers requires promoting dementia-friendly communities (DFC). However, little is known regarding older Taiwanese Aboriginal PWDS' experiences of living in the community. We explored these experiences for older Atayal PWDS and their families in Taiwan. Research Design and Methods This grounded theory research used in-depth interviews to explore the perspectives of older PWDS (n = 4), their family members (n = 3), and key persons (n = 10) in an Atayal community in northern Taiwan. Data were analyzed using constant comparative analysis. Participants were interviewed between January and May 2015. Results Participants' experiences were captured by the overarching concept of "low dementia awareness, high family-like ambience in the community." Despite the low/absent community awareness of dementia, older Atayal PWDS functioned as freely in the community as at home due to a family-like supportive environment. Aboriginal PWDS and their families also faced environmental challenges, e.g., environmental constraints and barriers to transportation access. Discussion and Implications Our results suggest that this Aboriginal community and culture offer important DFC components, and these strengths could be further studied to enhance DFC models elsewhere. Despite these strengths in supporting PWDS, environmental challenges to transportation access still cause difficulties for PWDS and their families and need improvement. The Atayal community's low dementia awareness suggests that services introduced must be culturally appropriate and nondisruptive to existing supportive helping systems. Our study can be a model for future studies to understand and identify PWDS' needs in Indigenous communities. [ABSTRACT FROM AUTHOR]

• A link exists between NPC treated with RT and dementia development. • A 1.97-fold higher risk of dementia exists in NPC patients than in controls. • The occurrence of dementia seems earlier in NPC patients than in the controls. We evaluated the risk of dementia in patients with nasopharyngeal cancer (NPC) after undergoing radiation therapy (RT). Between January 1, 2000, and December 31, 2015, 594 patients newly diagnosed with NPC and treated with RT (NPC cohort) were identified from the Longitudinal Health Insurance Database (LHID) for this nationwide population-based matched cohort study. LHID is a subset of the National Health Insurance Research Database of Taiwan. We selected 2376 controls (non-NPC comparison cohort) using a four-fold propensity score-matched by sex, age, comorbidities, education level, tobacco abuse, and index date (the date when the patient received first RT). After adjusting for confounding factors, Fine and Gray's competing risk analysis compared dementia development between the NPC study cohort and non-NPC comparison cohort over the observation period from 2000 to 2015. Dementia development was 6.57% (39 of 594) and 4.42% (105 of 2376) in the NPC study cohort and non-NPC comparison cohort, respectively. Patients with NPC receiving RT were more likely to develop dementia than the comparison cohort, with a crude hazard ratio (HR) of 1.63 [95% confidence interval (CI) = 1.25–2.13, P < 0.001]. After adjusting for age, sex, education level, tobacco abuse, comorbidity, geographic area, urbanization level of the residence, and care level, the adjusted HR was 1.91 (95% CI = 1.42–2.51, P < 0.001). Patients with NPC receiving RT had a 1.91-fold higher risk of dementia than the non-NPC comparison controls. [ABSTRACT FROM AUTHOR]