Source: The Conversation – Canada – By Noelia Calvo, Research Associate, Neuroscience, University of Toronto
Why do some people maintain good memories and have healthy brains even as they age?
Research that my colleagues and I recently published in Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, explored the effects and interactions of social, linguistic and endocrinological factors on cognitive health.
With Canada’s aging population, the question of brain health is a relevant one. The most recent census in 2021 indicated that one in eight Canadians is aged 70 or over, and there are 1.7 million who are age 80 or older. These numbers show a growing population of older adults at increased risk of cognitive decline, highlighting the need to examine protective factors.
Previous research indicates that bilingualism may be a possible protective factor. Notably, the 2021 census indicated that bilingualism is also increasing among Canadians, with four in 10 (41 per cent) speaking more than one language.
While bilingualism may be one piece of the puzzle, other cognitive or biological factors also influence brain health. Verbal memory — the ability to remember words — has been linked to cognitive resilience. The presence of sex hormones such as estrogen and testosterone, which are present in both men and women, may also influence how the brain ages.
Studying a trio of factors
The relationship between these three factors — bilingualism, verbal memory and sex hormones — has not been studied before. To address this gap, my colleagues and I conducted a new study in Canada. We found that bilingualism may interact with verbal memory and sex hormones to influence dementia risk in unexpected ways.
Our study included data from 335 older adults with mild cognitive impairment and 170 patients with Alzheimer’s disease drawn from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) cohort, which is part of the Canadian Consortium on Neurodegeneration and Aging.
COMPASS-ND includes more than 1,200 Canadian adults aged 50–90 years recruited across more than 30 sites nationwide. Using this rich and current database, we examined how sex hormones, verbal memory and bilingualism jointly influence cognitive resilience, brain structure and blood-based markers of Alzheimer’s disease.
This article is part of our ongoing series The Grey Revolution. The Conversation Canada and La Conversation are exploring the impact of the aging boomer generation on Canadian society, including housing, working, culture, nutrition, travelling and health care. The series explores the upheavals already underway and those looming ahead.
We created a resilience index for each participant that incorporated sex hormones, verbal memory, bilingual proficiency, education, age and immigration status. Age, education, and immigration status were included as covariates because they may influence cognitive resilience through differences in language experiences, educational opportunities and sociocultural adaptation across the lifespan.
Each unit increase in the resilience index was associated with a significant reduction in the odds of dementia-related pathology. Higher resilience index scores were also linked to better performance on clinical diagnostic tools such as the Montreal Cognitive Assessment (MoCA), as well as lower levels of key markers associated with neurodegeneration and glial activation, a process in which the brain’s support cells become reactive in response to injury or disease.
Overall, bilingual participants showed the highest resilience index scores, but with notable differences in how these effects manifested across biological sex.
Our findings challenge the idea that risk and resilience can be understood by looking at biological or social factors in isolation. By studying bilingualism and sex hormones together, we reveal how these factors may interact to shape brain resilience.
Bilingualism and verbal memory
Another important finding of our study was related to verbal memory. Consistent with previous research, women showed better performance in verbal memory. This sex difference is clinically important because verbal memory is often used as a proxy for general cognitive function, meaning it can influence how dementia is diagnosed in women.
One might expect that bilingual women would be especially protected, since they have both the bilingualism benefit and strong verbal memory.
Surprisingly, our study found the opposite: bilingual men showed greater brain protection. Our findings suggested that a combination of two factors may be a mechanism behind enhanced verbal memory and cognitive resilience in aging men: aromatization — the conversion of testosterone into estradiol — and bilingual language experience.
In people with mild cognitive impairment, higher estradiol levels produced through aromatization, together with bilingualism, may work synergistically to protect verbal memory, making older bilingual men more resilient to cognitive decline and neurodegenerative pathology.
Overall, our study suggests that bilingual men may have greater resilience to neuropathology and that sex hormones could influence dementia risk in aging women. These findings underscore the need for more research on how sex hormones affect brain health, as well as the importance of using measures beyond verbal memory to improve the accuracy of cognitive decline diagnoses in Canada.
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The research discussed in this article was supported by external funding from the Synapse Challenge award, Canadian Consortium on Neurodegeneration (CCNA). The funding period has now concluded.
– ref. Bilingualism and sex hormones may provide a new link to brain resilience and dementia risk – https://theconversation.com/bilingualism-and-sex-hormones-may-provide-a-new-link-to-brain-resilience-and-dementia-risk-279490






