
Background The rise in life expectancy is associated with an increase in long-term and gradual cognitive decline. Treatment effectiveness is enhanced at the early stage of the disease. Therefore, there is a need to find low-cost and ecological solutions for mass screening of community-dwelling older adults. Objective This work aims to exploit automatic analysis of free speech to identify signs of cognitive function decline. Methods A sample of 266 participants older than 65 years were recruited in Italy and Spain and were divided into 3 groups according to their Mini-Mental Status Examination (MMSE) scores. People were asked to tell a story and describe a picture, and voice recordings were used to extract high-level features on different time scales automatically. Based on these features, machine learning algorithms were trained to solve binary and multiclass classification problems by using both mono- and cross-lingual approaches. The algorithms were enriched using Shapley Additive Explanations for model explainability. Results In the Italian data set, healthy participants (MMSE score≥27) were automatically discriminated from participants with mildly impaired cognitive function (20≤MMSE score≤26) and from those with moderate to severe impairment of cognitive function (11≤MMSE score≤19) with accuracy of 80% and 86%, respectively. Slightly lower performance was achieved in the Spanish and multilanguage data sets. Conclusions This work proposes a transparent and unobtrusive assessment method, which might be included in a mobile app for large-scale monitoring of cognitive functionality in older adults. Voice is confirmed to be an important biomarker of cognitive decline due to its noninvasive and easily accessible nature.
Male, Machine Learning, Mini-Mental Status Examination; cognitive decline; machine learning; multilanguage; speech processing, Humans, Speech, Cognitive Dysfunction, speech processing, Aged, Aged, 80 and over, Original Paper, RC952-954.6, Mini-Mental Status Examination, Electrical Engineering - Electronic Engineering - Information Engineering, cognitive decline, Mental Status and Dementia Tests, machine learning, Cross-Sectional Studies, Italy, Geriatrics, Spain, multilanguage, Engineering and Technology, Female, Algorithms
Male, Machine Learning, Mini-Mental Status Examination; cognitive decline; machine learning; multilanguage; speech processing, Humans, Speech, Cognitive Dysfunction, speech processing, Aged, Aged, 80 and over, Original Paper, RC952-954.6, Mini-Mental Status Examination, Electrical Engineering - Electronic Engineering - Information Engineering, cognitive decline, Mental Status and Dementia Tests, machine learning, Cross-Sectional Studies, Italy, Geriatrics, Spain, multilanguage, Engineering and Technology, Female, Algorithms
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