The association between multilingualism and cognitive function among literate and illiterate older adults with low education in India

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Introduction This study examined whether multilingualism modified the adverse effect of illiteracy on cognition among older Indian adults with low to no formal schooling. Methods Data came from the Longitudinal Aging Study in India‐Diagnostic Assessment of Dementia ( N = 2533, M age = 70.3 years, 84% illiterate, 24% multilingual, ≤4 years of education). Generalized linear models and propensity score matching assessed whether multilingualism modified the association between illiteracy and domain‐specific cognition. Results Illiteracy was negatively associated with cognition, while multilingualism was positively associated. While multilingualism did not buffer the association of illiteracy, it did increase the positive association of literacy with executive functioning and memory. Discussion These findings highlight the detrimental effects of illiteracy on cognition, while multilingualism appears beneficial among older adults with low to no formal schooling. The benefits of multilingualism, however, were diminished in illiterate compared to literate older adults, suggesting that limited early‐life educational opportunities can weaken its contribution to cognition. Highlights We examined if multilingualism buffers the negative impact of illiteracy on cognition. Illiteracy was associated with worse cognition, while multilingualism had a positive effect. Multilingualism did not protect cognition from the negative effect of illiteracy. However, multilingualism strengthened the positive impact of literacy on cognition. Results suggest that multilingualism's cognitive benefits vary by early‐life educational opportunities.