Cross-Task Generalization in Handwriting-Based Alzheimer's Screening via Vision Language Adaptation

Online handwriting provides a non-invasive and low-cost behavioral biomarker for Alzheimer's disease (AD) detection, as it reflects both cognitive planning and fine motor control. Existing handwriting-based AD detection methods usually rely on global trajectory features or whole-sample representations, which can be strongly affected by individual writing style, task-specific variation, and acquisition noise. In this paper, we propose NormPaST-Risk, a healthy-normative Paper-Air selective trajectory state-space risk network for interpretable AD detection from online handwriting. Instead of treating the entire trajectory as a single holistic representation, our method reformulates AD handwriting detection as local disease-relevant segment discovery. Specifically, a multi-scale temporal encoder captures stroke dynamics at different temporal resolutions, while a selective Paper-Air state-space encoder models long-range handwriting progression and distinguishes on-paper motor execution from in-air planning and transition behaviors. To explicitly characterize abnormal deviations, a healthy normative branch learns normal handwriting dynamics from healthy controls, and a task-aware multi-expert segment-risk module estimates segment-level AD risk calibrated by hidden-state changes and normative deviations. A weakly supervised segment-level objective further enables high-risk segment discovery without manual segment annotations. Experiments on the DARWIN benchmark demonstrate that the proposed framework achieves superior AD/HC classification performance compared with existing methods. Moreover, the discovered high-risk segments can be projected back to the original handwriting trajectory, providing interpretable evidence associated with AD-related handwriting variations.

The development of multilingual Alzheimer's Disease Dementia (AD) detection models presents significant challenges due to the resource-intensive and time-consuming nature of language-specific model training. We propose a novel solution using cross-language training to detect AD in languages beyond those used for model training. This study investigates multilingual deep learning models for detecting AD across different languages and cognitive impairment levels. Using datasets in English, Chinese, Arabic, and Hindi, we developed transformer-based models for binary AD classification. Our approach achieved F1 scores of 82% across all languages, demonstrating strong cross-linguistic generalization. The rapid inference time (0.5 seconds) supports potential real-time screening applications, while consistent performance across languages indicates feasibility for global deployment.

Early diagnosis of Alzheimer's disease (AD) is critical for enabling timely interventions that may slow disease progression and improve patient outcomes. There is a growing need for AD detection methods that are non-invasive and cost-effective, especially in real-world clinical settings with diverse patient populations and recording conditions. Speech-based screening addresses these needs by using natural speech collected without specialized equipment. Recent advances in large language models (LLMs) have improved speech analysis by providing rich linguistic representations and strong generalization. In this study, we propose LSEAD, a speech-based AD detection framework using pretrained open-source LLMs. Speech recordings are automatically transcribed, and text embeddings are extracted using locally deployed LLMs. Principal component analysis (PCA) is applied to reduce dimensionality before classification. Because the framework relies only on speech transcripts and locally deployed models, it supports privacy-preserving AD risk assessment without external data exchange. We evaluate LSEAD on the ADReSS20 and ADReSSo2021 benchmark datasets. Experimental results show that LLM-based embeddings generalize well across datasets and improve AD classification accuracy by up to 5 percent over existing methods, especially for early-stage detection. These results demonstrate that LSEAD provides a practical, secure, and scalable approach for early AD screening.