The devastating effect of Alzheimer's disease on bilingual people has been thrown into focus in Canada, where the sudden loss of a second language can leave sufferers feeling like strangers in their own country.
Despite increasing evidence that bilingualism can actually delay the onset of dementia, those grappling with the ravages of the disease often find themselves isolated by the lack of essential services in their language of choice.
When Alzheimer's strikes, an people's ability to communicate in their second language often erodes rapidly.
Sylvie Lavoie told AFP she noticed a steady deterioration in her mother's ability to speak English fluently after she was diagnosed with the disease.
Her mother, Helene Tremblay-Lavoie, later took a test to measure her deterioration that provided conclusive evidence.
She scored nine marks out of 30 for a test in English contrasted with 19 out of 30 for the same test in French.
"The result was a terrible shock, a huge surprise," Lavoie told AFP. "Talking in French to my mother I had not noticed that she had lost her English.
"I noticed that she was speaking less and less English to my husband, who is anglophone, but I attributed that to the illness and general fatigue."
The case garnered attention in Canada. Tremblay-Lavoie was born in the French-speaking province of Quebec and lived in Toronto for 30 years, becoming fully bilingual.
However, when it came to finding a facility capable of caring for her mother, Lavoie discovered nothing was available for her mother in Toronto.
She eventually found a spot in a French-speaking hospice in the town of Welland, near Niagara Falls.
In response to the shortfall of spaces, the Helene Tremblay-Lavoie Foundation was set up last year with the goal of creating long-term care for francophones in the Toronto region.
"People who lose the ability to speak English are unilingual francophones who have learned English later in life," said Guy Proulx, a professor at York University who specializes in the assessment and rehabilitation of cognitive disorders in people suffering from strokes or dementia.
Proulx, a director of the foundation, cautioned that individuals who had been bilingual since childhood were less likely to lose the use of their second language.
"A bilingual from childhood won't lose it because it is automated, it is anchored in. When it is automated, it is more resistant to diseases like Alzheimer's," he explained.
Proulx and the foundation are hoping to set up a dedicated francophone clinic in the Toronto region that will feature a research center in the field of cognitive health and therapy for diseases like Alzheimer's.
Nearly 90 percent of francophones in Toronto—some 125,000 people out of a population of 600,000 across Ontario—are in relationships with non-francophones. The aim is to ensure these people can stay together when the disease strikes.
"Health care services in French are available in Toronto but they are scattered. They need to be structured," said Proulx.
Jean Roy, who chairs the foundation's board, said it had the support of the provincial and federal governments.
"The project will cost Can$200,000 per year for three years and we already have the money. It is only going to be a matter of months."