Deep learning systems often struggle with processing long sequences, where computational complexity can become a bottleneck. Current methods for automated dementia detection using speech frequently rely on static, time-agnostic features or aggregated linguistic content, lacking the flexibility to model the subtle, progressive deterioration inherent in speech production. These approaches often miss the dynamic temporal patterns that are critical early indicators of cognitive decline. In this paper, we introduce TAI-Speech, a Temporal Aware Iterative framework that dynamically models spontaneous speech for dementia detection. The flexibility of our method is demonstrated through two key innovations: 1) Optical Flow-inspired Iterative Refinement: By treating spectrograms as sequential frames, this component uses a convolutional GRU to capture the fine-grained, frame-to-frame evolution of acoustic features. 2) Cross-Attention Based Prosodic Alignment: This component dynamically aligns spectral features with prosodic patterns, such as pitch and pauses, to create a richer representation of speech production deficits linked to functional decline (IADL). TAI-Speech adaptively models the temporal evolution of each utterance, enhancing the detection of cognitive markers. Experimental results on the DementiaBank dataset show that TAI-Speech achieves a strong AUC of 0.839 and 80.6\% accuracy, outperforming text-based baselines without relying on ASR. Our work provides a more flexible and robust solution for automated cognitive assessment, operating directly on the dynamics of raw audio.

Text-to-image models generate highly realistic images based on natural language descriptions and millions of users use them to create and share images online. While it is expected that such models can align input text and generated image in the same latent space little has been done to understand whether this alignment is possible between pathological speech and generated images. In this work, we examine the ability of such models to align dementia-related speech information with the generated images and develop methods to explain this alignment. Surprisingly, we found that dementia detection is possible from generated images alone achieving 75% accuracy on the ADReSS dataset. We then leverage explainability methods to show which parts of the language contribute to the detection.

Dementia is a devastating condition with profound implications for individuals, families, and healthcare systems. Early and accurate detection of dementia is critical for timely intervention and improved patient outcomes. While classical machine learning and deep learning approaches have been explored extensively for dementia prediction, these solutions often struggle with high-dimensional biomedical data and large-scale datasets, quickly reaching computational and performance limitations. To address this challenge, quantum machine learning (QML) has emerged as a promising paradigm, offering faster training and advanced pattern recognition capabilities. This work aims to demonstrate the potential of quantum transfer learning (QTL) to enhance the performance of a weak classical deep learning model applied to a binary classification task for dementia detection. Besides, we show the effect of noise on the QTL-based approach, investigating the reliability and robustness of this method. Using the OASIS 2 dataset, we show how quantum techniques can transform a suboptimal classical model into a more effective solution for biomedical image classification, highlighting their potential impact on advancing healthcare technology.

Deep transformer models have been used to detect linguistic anomalies in patient transcripts for early Alzheimer's disease (AD) screening. While pre-trained neural language models (LMs) fine-tuned on AD transcripts perform well, little research has explored the effects of the gender of the speakers represented by these transcripts. This work addresses gender confounding in dementia detection and proposes two methods: the $\textit{Extended Confounding Filter}$ and the $\textit{Dual Filter}$, which isolate and ablate weights associated with gender. We evaluate these methods on dementia datasets with first-person narratives from patients with cognitive impairment and healthy controls. Our results show transformer models tend to overfit to training data distributions. Disrupting gender-related weights results in a deconfounded dementia classifier, with the trade-off of slightly reduced dementia detection performance.

Dementia, a progressive neurodegenerative disorder, affects memory, reasoning, and daily functioning, creating challenges for individuals and healthcare systems. Early detection is crucial for timely interventions that may slow disease progression. Large pre-trained models (LPMs) for text and audio, such as Generative Pre-trained Transformer (GPT), Bidirectional Encoder Representations from Transformers (BERT), and Contrastive Language-Audio Pretraining (CLAP), have shown promise in identifying cognitive impairments. However, existing studies generally rely heavily on expert-annotated datasets and unimodal approaches, limiting robustness and scalability. This study proposes a context-based multimodal method, integrating both text and audio data using the best-performing LPMs in each modality. By incorporating contextual embeddings, our method improves dementia detection performance. Additionally, motivated by the effectiveness of contextual embeddings, we further experimented with a context-based In-Context Learning (ICL) as a complementary technique. Results show that GPT-based embeddings, particularly when fused with CLAP audio features, achieve an F1-score of $83.33\%$, surpassing state-of-the-art dementia detection models. Furthermore, raw text data outperforms expert-annotated datasets, demonstrating that LPMs can extract meaningful linguistic and acoustic patterns without extensive manual labeling. These findings highlight the potential for scalable, non-invasive diagnostic tools that reduce reliance on costly annotations while maintaining high accuracy. By integrating multimodal learning with contextual embeddings, this work lays the foundation for future advancements in personalized dementia detection and cognitive health research.

Dementia is a neurodegenerative disease that causes gradual cognitive impairment, which is very common in the world and undergoes a lot of research every year to prevent and cure it. It severely impacts the patient's ability to remember events and communicate clearly, where most variations of it have no known cure, but early detection can help alleviate symptoms before they become worse. One of the main symptoms of dementia is difficulty in expressing ideas through speech. This paper attempts to talk about a model developed to predict the onset of the disease using audio recordings from patients. An ASR-based model was developed that generates transcripts from the audio files using Whisper model and then applies RoBERTa regression model to generate an MMSE score for the patient. This score can be used to predict the extent to which the cognitive ability of a patient has been affected. We use the PROCESS_V1 dataset for this task, which is introduced through the PROCESS Grand Challenge 2025. The model achieved an RMSE score of 2.6911 which is around 10 percent lower than the described baseline.

Speech is usually used for constructing an automatic Alzheimer's dementia (AD) detection system, as the acoustic and linguistic abilities show a decline in people living with AD at the early stages. However, speech includes not only AD-related local and global information but also other information unrelated to cognitive status, such as age and gender. In this paper, we propose a speech-based system named Swin-BERT for automatic dementia detection. For the acoustic part, the shifted windows multi-head attention that proposed to extract local and global information from images, is used for designing our acoustic-based system. To decouple the effect of age and gender on acoustic feature extraction, they are used as an extra input of the designed acoustic system. For the linguistic part, the rhythm-related information, which varies significantly between people living with and without AD, is removed while transcribing the audio recordings into transcripts. To compensate for the removed rhythm-related information, the character-level transcripts are proposed to be used as the extra input of a word-level BERT-style system. Finally, the Swin-BERT combines the acoustic features learned from our proposed acoustic-based system with our linguistic-based system. The experiments are based on the two datasets provided by the international dementia detection challenges: the ADReSS and ADReSSo. The results show that both the proposed acoustic and linguistic systems can be better or comparable with previous research on the two datasets. Superior results are achieved by the proposed Swin-BERT system on the ADReSS and ADReSSo datasets, which are 85.58\% F-score and 87.32\% F-score respectively.

The close link between cognitive decline and language has fostered long-standing collaboration between the NLP and medical communities in dementia research. To examine this, we reviewed over 200 papers applying NLP to dementia related efforts, drawing from medical, technological, and NLP-focused literature. We identify key research areas, including dementia detection, linguistic biomarker extraction, caregiver support, and patient assistance, showing that half of all papers focus solely on dementia detection using clinical data. However, many directions remain unexplored: artificially degraded language models, synthetic data, digital twins, and more. We highlight gaps and opportunities around trust, scientific rigor, applicability, and cross-community collaboration, and showcase the diverse datasets encountered throughout our review: recorded, written, structured, spontaneous, synthetic, clinical, social media based, and more. This review aims to inspire more creative approaches to dementia research within the medical and NLP communities.

The lack of labeled data is a common challenge in speech classification tasks, particularly those requiring extensive subjective assessment, such as cognitive state classification. In this work, we propose a Semi-Supervised Learning (SSL) framework, introducing a novel multi-view pseudo-labeling method that leverages both acoustic and linguistic characteristics to select the most confident data for training the classification model. Acoustically, unlabeled data are compared to labeled data using the Frechet audio distance, calculated from embeddings generated by multiple audio encoders. Linguistically, large language models are prompted to revise automatic speech recognition transcriptions and predict labels based on our proposed task-specific knowledge. High-confidence data are identified when pseudo-labels from both sources align, while mismatches are treated as low-confidence data. A bimodal classifier is then trained to iteratively label the low-confidence data until a predefined criterion is met. We evaluate our SSL framework on emotion recognition and dementia detection tasks. Experimental results demonstrate that our method achieves competitive performance compared to fully supervised learning using only 30% of the labeled data and significantly outperforms two selected baselines.

The rapid global aging trend has led to an increase in dementia cases, including Alzheimer's disease, underscoring the urgent need for early and accurate diagnostic methods. Traditional diagnostic techniques, such as cognitive tests, neuroimaging, and biomarker analysis, face significant limitations in sensitivity, accessibility, and cost, particularly in the early stages. This study explores the potential of machine learning (ML) as a transformative approach to enhance early dementia detection by leveraging ML models to analyze and integrate complex multimodal datasets, including cognitive assessments, neuroimaging, and genetic information. A comprehensive review of existing literature was conducted to evaluate various ML models, including supervised learning, deep learning, and advanced techniques such as ensemble learning and transformer models, assessing their accuracy, interpretability, and potential for clinical integration. The findings indicate that while ML models show significant promise in improving diagnostic precision and enabling earlier interventions, challenges remain in their generalizability, interpretability, and ethical deployment. This research concludes by outlining future directions aimed at enhancing the clinical utility of ML models in dementia detection, emphasizing interdisciplinary collaboration and ethically sound frameworks to improve early detection and intervention strategies for Alzheimer's disease and other forms of dementia.