Early detection is crucial for timely intervention aimed at preventing and slowing the progression of neurocognitive disorder (NCD), a common and significant health problem among the aging population. Recent evidence has suggested that language-related functional magnetic resonance imaging (fMRI) may be a promising approach for detecting cognitive decline and early NCD. In this paper, we proposed a novel, naturalistic language-related fMRI task for this purpose. We examined the effectiveness of this task among 97 non-demented Chinese older adults from Hong Kong. The results showed that machine-learning classification models based on fMRI features extracted from the task and demographics (age, gender, and education year) achieved an average area under the curve of 0.86 when classifying participants' cognitive status (labeled as NORMAL vs DECLINE based on their scores on a standard neurcognitive test). Feature localization revealed that the fMRI features most frequently selected by the data-driven approach came primarily from brain regions associated with language processing, such as the superior temporal gyrus, middle temporal gyrus, and right cerebellum. The study demonstrated the potential of the naturalistic language-related fMRI task for early detection of aging-related cognitive decline and NCD.

Functional magnetic resonance imaging (fMRI) is essential for developing encoding models that identify functional changes in language-related brain areas of individuals with Neurocognitive Disorders (NCD). While large language model (LLM)-based fMRI encoding has shown promise, existing studies predominantly focus on healthy, young adults, overlooking older NCD populations and cognitive level correlations. This paper explores language-related functional changes in older NCD adults using LLM-based fMRI encoding and brain scores, addressing current limitations. We analyze the correlation between brain scores and cognitive scores at both whole-brain and language-related ROI levels. Our findings reveal that higher cognitive abilities correspond to better brain scores, with correlations peaking in the middle temporal gyrus. This study highlights the potential of fMRI encoding models and brain scores for detecting early functional changes in NCD patients.