Health: Stroke Survivors

Baroness Coussins Excerpts

Thursday 28th June 2018 Grand Committee

[Baroness Coussins (CB)]

My Lords, I declare an interest as co-chair of the All-Party Group on Modern Languages. I quite understand if, at this point, other noble Lords wonder if I have wandered into the wrong debate, but please bear with me as I hope to convince noble Lords that there is an important link between the recovery of stroke victims and languages. This is borne out by robust research and has the potential to bring significant benefits to patients, as well as leading to some cost-effective decisions for the NHS.

In January this year, the All-Party Group on Modern Languages heard from a panel of experts on the cognitive benefits of learning a second or subsequent language. The panel comprised, among others, the neuroscientist Dr Thomas Bak of Edinburgh University, who is president of the cognitive disorders research group of the World Federation of Neurology. His main clinical research interest is the relationship between language, cognition and the brain. He was accompanied by Dr Dina Mehmedbegovic from University College London’s Institute of Education. She is developing interdisciplinary work with neuroscientist colleagues to provide a broader evidence base for advocating the cognitive benefits of lifelong language learning.

The bottom line is that people who speak more than one language recover cognitively from strokes more successfully than those who do not. In Dr Bak’s study of 2015:

“The percentage of patients with intact cognitive functions post stroke was more than twice as high in bilinguals than in monolinguals”,


and,

“bilingualism emerged as an independent predictor of poststroke cognitive impairment”.

For the sake of clarity, I emphasise—with Dr Bak’s authority—that the word “bilingual” in this context means simply having the ability to communicate, not having a perfect command of a language. His detailed findings included that 40.5% of bilinguals had normal cognitive functions after a stroke, compared to only 19.6% of monolinguals. Looking at that the other way round, he found that that only 49% of bilinguals had cognitive impairment after a stroke, compared with 77.7% of monolinguals. This research was reported in 2015 in the American Stroke Association journal. A further significant finding was that late acquisition of another language has a similar protective effect to early acquisition. It is never too late to start learning another language in order to benefit in this way.

Research has also examined the impact which learning and using more than one language had on delaying the onset of Alzheimer’s and other forms of dementia, and found that it can indeed cause a delay of four to five years, including for vascular dementia, which is the type caused by strokes. Similarly with aphasia, a common language disorder caused by brain damage such as stroke, bilingualism leads to less severe impairment and better recovery. This finding was reported by Paplikar et al earlier in 2018. Dr Bak is involved in a project in Scotland, in partnership with Alzheimer Scotland and Edinburgh University, and supported by an ESRC grant. It is called Lingo Flamingo, and teaches languages to Alzheimer’s sufferers to improve their cognitive resilience.

Will the Minister consider supporting a similar initiative in England and Wales for stroke survivors? Drs Bak and Mehmedbegovic argue that, by increasing multilingualism in the population, we could expect to reduce the incidence of dementia, saving billions of pounds. I understand that the current total cost of dementia care is around £26 billion a year. Exactly the same argument can be made for the long-term treatment of stroke survivors, and I hope that the Minister will agree to take this proposition back to the department.

As always in scientific research, there are some discrepancies in findings across different studies, but on this proposition—that learning and using more than one language improves long-term recovery after a stroke—there is now converging evidence from different studies, different populations, different countries and even different continents that supports the conclusions that I have highlighted. However, to transform the research findings into practical policy, we need to change the general attitude towards language learning in the UK. I am pleased to say that, following the APPG meeting that I referred to earlier, Nick Gibb, the Schools Minister, requested further details of the research for the Department for Education to consider. The DfE’s interest of course lies in the cognitive benefits of language learning for children, of which there are also plenty, although not for elaboration in today’s debate. However, the Minister here today will, I hope, be sufficiently interested and intrigued by my contribution also to want to follow up this innovative research and find out more.

Dr Bak says that,

“promoting language learning and use is one of the cheapest, simplest and most effective means of improving cognitive functions across all ages”,

and he points out that the work of the Lingo Flamingo project is scalable, so if funds were available for a pilot project for stroke survivors, he could have it up and running within months. This would be a fast and measurable initiative. Is the Minister tempted to find out more and would he like me to arrange a meeting for him with Dr Bak?