Cognitive Assessment in the Bilingual Patient

Cognitive function testing depends on multiple factors, which involve an ability to understand the language in patients and doctors and the cultural background. Many testing tools are translated into other languages except for English. For instance, the Mini-Mental State Examination (MMSE) and the Saint Louis University Mental Status (SLUMS) can be found in various translations for the convenience of the examination (Olmedo et al., 2018). After analyzing the case, it is essential to understand why MMSE and SLUMS indicators changed over six months and discuss the importance of testing in the two languages for bilingual patients to grasp the influence on cognitive abilities.

It is necessary to consider which cognitive functions MMSE and SLUMS measure. MMSE is used for cognitive assessment of “language, concentration, working memory, memory recall, orientation,” and some other organism functions (Eftekhari et al., 2018, p. 12). SLUMS covers eleven questions, including animal naming, figure recognition, clock drawing, and other interaction abilities with objects. It is crucial to arrange testing in the most convenient language for the patient to avoid distortion of results. The patient claimed that he could speak either Spanish or English and perform in both languages irrespective of the language shift. According to the testing results in English, the patient received thirteen scores out of thirty. However, when the language was shifted into his native Spanish, he received a twenty-one score. Although the patient feels comfortable with English, some sources suggest that the native language reflects familiar “values and perceptions” (Olmedo et al., 2018, para 1). Moreover, the treatment prescribed to the man was not appropriate, and “the findings were noncontributory” (Olmedo et al., 2018, para 2). It proves that the conversion to the native language facilitated better results in the patient and improved indicators of MMSE and SLUMS through six months of the treatment.

Tasks on attention, recall, orientation, naming, and other aspects require diligent work of the patient’s cognitive abilities. These functions are brain skills necessary for analyzing information and developing memory. While learning the language, the brain works actively, and cognitive mechanisms are involved. Many people learn foreign languages for various purposes; however, they can forget information without constant practice. It might seem evident that people rarely forget their native language, as it is embedded in the person from early childhood’s nurturing.

People usually feel more comfortable communicating in their native language, as it is a daily tool to use with family and friends. Therefore, the ability to recognize the native language is stronger than the cognition of the second language, as it is “constrained by processing limitations” (Hulstijn, 2018, p. 175). Thus, it is possible to suggest certain cognitive limitations on using the second language as the main source of linguistic information. Moreover, the testing in the native language might significantly affect the result due to cognitive features of the human brain, which keeps the native language as a primary source of communication. In contrast, there is a big chance to forget the second language partially or entirely.

Overall, it was investigated that the person’s cognitive abilities rely on brain peculiarities on analyzing and keeping the information. It becomes clear that bilingual patients mostly feel free to speak their native language rather than the perceived one, as the first language reflects familiar memories and values. Therefore, it is clear that MMSE and SLUMS testing demonstrated better results after shifting into the patient’s native language. The source has shown that medicines did not display a significant effect. Thus, it is feasible to rely on the relevance of the shift into the patient’s first language.


Eftekhari, S. S., Hejazi, S. A., Sharifipour, E., Hejazi, S. F., Talebizadeh, M., Mostafavi, H., & Yoosefee, S. (2018). Cognitive impairment in patients with coronary artery disease; comparison of Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Journal of Advances in Medical and Biomedical Research, 26(119), 12–16. Web.

Hulstijn, J. H. (2018). An individual-differences framework for comparing nonnative with native speakers: Perspectives from BLC theory. Language Learning, 69, 157–183. Web.

Olmedo, B., Berg, K. M., Mejnartowicz, S., & Walke, L.M. (2012). Lost in translation: Confronting issues of cognitive assessment for a bilingual older adult. Consultant 360, 20(6). Web.

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PsychologyWriting. "Cognitive Assessment in the Bilingual Patient." February 25, 2023.