Forgotten Words: Benchmarking NeoBERT for Dementia Detection in Low-Resource Conversational Filipino and English Speech

Speech recruits the same executive, attentional, and working memory processes underlying instrumental activities of daily living, or IADLs, providing a non-invasive proxy for cognitive assessment. Yet most speech-based dementia detection systems depend on transcription, discard within-recording temporal structure, and are validated on a single English corpus with known recording artifacts. We propose an ASR-agnostic framework operating directly on Mel spectrograms. Our key contribution is extracting spectrotemporal displacement fields from consecutive spectrogram frames, capturing shifting spectral energy patterns as digital biomarkers of cognitive decline. These features are fused with CNN-ConvGRU acoustic embeddings via a learned cross-attention mechanism and aggregated using a Transformer encoder with learnable query pooling. A composite temporal loss enforces smoothness and contrastive coherence across segments. We train independent models on English DementiaBank, Slovak EWA-DB, and Spanish Ivanova corpora, using clinical elicitation protocols taxing IADL-relevant cognitive domains. The Slovak model achieves 83.9% accuracy, and Spanish achieves, while the English baseline yields 53.2%, confirming known artifacts. Cross-lingual ablation studies reveal distinct fusion regimes: removing cross-attention collapses Spanish performance to 53.7%, below unimodal models, while the Slovak audio encoder alone outperforms the full model, 93.7% vs. 83.9%, and all English configurations remain near chance. Thus, multimodal fusion's value is corpus-dependent: essential when signal is distributed across modalities, counterproductive when one dominates, and irrelevant when no signal exists. Auxiliary temporal losses converge to language-invariant values, indicating cross-lingual architectural stability.

Early detection of dementia enables timely intervention, and reflecting cognitive impairment, spontaneous speech offers a non-invasive screening modality. Conventional approaches often focus on a single representational dimension -- such as acoustic descriptors, pause modeling, automatic speech recognition (ASR) transcripts, or multimodal fusion -- limiting integrative reasoning across heterogeneous cognitive symptoms. We propose a low-rank adaptation (LoRA)-tuned large language model (LLM) that performs structured multi-view reasoning over four complementary speech-derived signals: ASR transcripts with pause markers, discourse-level topic cues, temporal fluency statistics, and phonological sequences. These cues are encoded within a unified prompt, enabling a single LLM to learn a coherent decision function without modality-specific encoders or late-stage fusion. On ADReSSo, our best model achieves an F1-score of 90.14%, and ablation confirms the complementary contribution of each view.

Early detection of dementia through speech analysis offers a non-invasive screening alternative, but capturing both acoustic and linguistic biomarkers remains challenging. We propose a multimodal framework leveraging Whisper for dual-purpose extraction: acoustic representations from encoder outputs and transcripts via automatic speech recognition (ASR). For the acoustic pathway, temporal networks with attention pooling aggregate variable-length sequences into fixed-dimensional embeddings. For the linguistic pathway, we prompt a large language model (LLM) to extract interpretable features spanning lexical diversity, syntactic complexity, semantic coherence, and discourse patterns. A gated fusion network integrates both modalities. On ADReSS and ADReSSo, our method achieves F1-scores of 89.47% and 90.14%, demonstrating effective integration of acoustic and LLM-augmented linguistic features. Ablation shows that multimodal fusion consistently outperforms either modality alone.