It is still hard to find Alzheimer's disease (AD) early, especially when neuroimaging is expensive or tools that depend on language are not available. Spontaneous speech provides a non-invasive signal; however, numerous current methodologies depend on transcripts/ASR or computationally intensive deep models. We offer a simple, audio-only baseline for detecting AD using 176 Cookie Theft recordings from the DementiaBank Pitt corpus (88 AD, 88 controls). WebRTC voice activity detection (VAD) is used to separate speech from non-speech. We take out 99 hand-crafted acoustic-temporal features, including pause and fluency statistics, spectral/prosodic descriptors, and MFCC summaries with Δ and ΔΔ. Evaluation is performed using a stringent speaker-independent GroupShuffleSplit,documenting performance across 30 iterations. A lightweight SVM with an RBF kernel gets an average AUC of 0.674 across runs. For example, a single split has an AUC of 0.742 and an accuracy of 0.657. We also present an exploratory compact-feature analysis utilizing a Top-20 subset ranked by Random Forest importance; since selection is not nested within training splits, these results may be overly optimistic and are not employed for primary conclusions (AUC 0.719). The results indicate that transcript-free spectro-temporal and fluency-related cues can facilitate speaker-independent Alzheimer's disease screening from raw audio, establishing a practical foundation for deployment-oriented research.
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.
Alzheimer's disease (AD) is a progressive neurodegenerative disorder and the leading cause of dementia, affecting memory, reasoning, communication, and daily functioning. Early diagnosis is particularly important, as timely intervention may help slow cognitive decline and improve patient care. Recent studies have demonstrated that spontaneous speech contains valuable linguistic and acoustic biomarkers associated with dementia. However, existing approaches often rely on independently trained modality-specific models, feature concatenation strategies, ensemble methods, or attention-based fusion mechanisms that do not explicitly maximize the dependency between speech and transcript representations. In this work, we propose a multimodal deep learning framework for automatic dementia detection that jointly exploits speech and transcript information in an end-to-end trainable manner. Specifically, speech recordings are divided into 10-second segments and passed through a pre-trained HuBERT model to extract contextualized acoustic representations. To better capture informative temporal speech characteristics, attentive statistics pooling is employed to aggregate frame-level acoustic embeddings. For the textual modality, transcripts are encoded using a pre-trained BERT model, where the [CLS] token representation is used as the linguistic embedding. The acoustic and textual representations are subsequently combined using an attention-based Audio-Text Fusion (AT-Fusion) mechanism. In addition, we introduce a MINE objective to maximize the mutual information between modalities and improve multimodal representation alignment. The fused multimodal representation is finally used for dementia classification. Experiments conducted on the publicly available ADReSS Challenge and PROCESS-2 dataset demonstrate the effectiveness and robustness of the proposed approach for speech-based dementia assessment.
Speech-based Alzheimer's disease (AD) detection increasingly relies on speech-enhanced and curated versions of the Pitt Corpus, where speech enhancement, sample selection, and demographic balancing are often treated as beneficial preprocessing steps. However, whether these transformations improve real-world AD detection or instead affect model generalization and prediction behavior remains unclear. In this work, we revisit the role of speech preprocessing and dataset curation across widely used benchmarks for speech-based AD detection. We evaluate the speech quality of different datasets, the cross-dataset generalization of multiple deep learning models under matched and mismatched enhancement settings, and the behavior of several recent large audio-language models (LALMs). Experimental results show that across multiple supervised speech models, speech-enhanced datasets often improve in-domain performance while reducing robustness in cross-domain evaluation. Matched enhancement between training and test data alleviates, but does not eliminate, this degradation. LALMs show a similar sensitivity: enhanced datasets induce stronger class imbalance and prediction shifts than unprocessed data. These results suggest that speech preprocessing and dataset curation can substantially influence downstream AD detection behavior, indicating that ``cleaner'' speech datasets are not necessarily more reliable for real-world AD detection.