Segment-Level Risk Discovery in Online Handwriting for Alzheimer's Disease Detection
Authors: Changqing Gong, Huafeng Qin, Mounîm A. El-Yacoubi
Organizations: Telecom SudParis, Institut Polytechnique de Paris, 91120 Palaiseau, France · School of Computer Science and Information Engineering, Chongqing Technology and Business University, Chongqing 400067, China
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.
Alzheimer's disease (AD) is a prevalent neurodegenerative disorder for which early detection is critical. Handwriting, which can be disrupted by subtle motor and cognitive decline, provides a non-invasive and cost-effective window for AD screening. Existing handwriting-based AD studies mostly rely on online trajectories and hand-crafted features, while the influence of handwriting task type on diagnostic performance and cross-task generalization remains underexplored. Meanwhile, large-scale vision--language models have demonstrated strong transfer and adaptation ability in natural-image anomaly detection and several medical modalities, such as chest X-ray and brain MRI. However, handwriting-based disease detection remains unexplored within this paradigm. To address this gap, we introduce a lightweight Cross-Layer Fusion Adapter (CLFA) framework that repurposes Contrastive Language--Image Pre-training (CLIP) for handwriting-based AD screening. CLFA inserts multi-level adapters into a frozen visual encoder, combining cross-layer feature fusion with depthwise 2D convolution on patch grids to capture both local stroke irregularities and higher-level handwriting structure. This design progressively aligns pretrained vision--language representations with AD-related handwriting cues and supports transfer from supervised source tasks to task-disjoint unseen target tasks. On the Darwin dataset, under the subject-disjoint cross-task protocol, averaged over all 600 task-disjoint source-target pairs, CLFA achieves 74.63% AUC, 74.85% accuracy, and 73.72% F1 score, outperforming the best competing model by 2.15, 1.79, and 1.87 percentage points, respectively.
Identifying reliable Alzheimer's disease (AD) markers typically requires manual, labor-intensive transcription and expert analysis, limiting its scale. We introduce an automated pipeline that extracts qualitative knowledge about potential AD progression indicators directly from audio recordings of verbal fluency tests. Our method uses pretrained foundation models to process raw audio and extract clinically relevant variables to construct a Bayesian Network (BN); this BN is used to reason about the AD progression markers and infer their qualitative relationships. Our system successfully recovers known clinical knowledge and identifies novel relationships between linguistic markers.
Alzheimers disease (AD) is a brain disorder that develops slowly and mainly affects memory, thinking, language, and daily activities. It is one of the most common causes of dementia and creates many difficulties for patients as well as their families. In the early stage, the symptoms are often mild and may look like normal ageing. For this reason, many people are diagnosed late, when the disease has already progressed. At present, there is no complete cure for AD. Still, early detection can help doctors manage the condition better and take suitable steps at the right time. In this study, a machine learning model is proposed to detect the early stages of Alzheimers disease using clinical details, neuropsychological test scores, and neuroimaging-related measures. The data used in this work is collected from the Alzheimers Disease Neuroimaging Initiative (ADNI). As the dataset has missing values, iterative imputation is applied to fill them. The dataset also has class imbalance, which is handled using Borderline SVM-SMOTE. After that, feature selection is carried out using wrapper-based and embedded methods so that only important features are used for training. The selected features are divided into training and testing sets, and feature scaling is applied. A stacking ensemble model is developed using Logistic Regression, Extra Trees, Bagging KNN, and LightGBM as base classifiers. Along with this, an artificial neural network is also trained on the same dataset. The performance of these models is compared using precision, recall, F1-score, and AUC-ROC. This study aims to find the best classifier and also identify important biomarkers that may help in the early diagnosis of Alzheimers disease.