Automatic speech analysis to early detect functional cognitive decline in elderly population

This study aimed at evaluating whether people with a normal cognitive function can be discriminated from subjects with a mild impairment of cognitive function based on a set of acoustic features derived from spontaneous speech. Voice recordings from 90 Italian subjects (age >65 years; group 1: 47 subjects with MMSE>26; group 2: 43 subjects with 20≤ MMSE ≤26) were collected. Voice samples were processed using a MATLAB-based custom software to derive a broad set of known acoustic features. Linear mixed model analyses were performed to select the features able to significantly distinguish between groups. The selected features (% of unvoiced segments, duration of unvoiced segments, % of voice breaks, speech rate, and duration of syllables), alone or in addition to age and years of education, were used to build a learning-based classifier. The leave-one-out cross validation was used for testing and the classifier accuracy was computed. When the voice features were used alone, an overall classification accuracy of 0.73 was achieved. When age and years of education were additionally used, the overall accuracy increased up to 0.80. These performances were lower than the accuracy of 0.86 found in a recent study. However, in that study the classification was based on several tasks, including more cognitive demanding tasks. Our results are encouraging because acoustic features, derived for the first time only from an ecologic continuous speech task, were able to discriminate people with a normal cognitive function from people with a mild cognitive decline. This study poses the basis for the development of a mobile application performing automatic voice analysis on-the-fly during phone calls, which might potentially support the detection of early signs of functional cognitive decline.

[1]  A. Kertesz,et al.  A study of language functioning in Alzheimer patients , 1982, Brain and Language.

[2]  Kathleen C. Fraser,et al.  Linguistic Features Identify Alzheimer's Disease in Narrative Speech. , 2015, Journal of Alzheimer's disease : JAD.

[3]  N. Sousa,et al.  Clinical, physical and lifestyle variables and relationship with cognition and mood in aging: a cross-sectional analysis of distinct educational groups , 2013, Front. Aging Neurosci..

[4]  F. Martínez-Sánchez,et al.  Voice Markers of Lexical Access in Mild Cognitive Impairment and Alzheimer's Disease. , 2018, Current Alzheimer research.

[5]  K. Forbes-McKay,et al.  Detecting subtle spontaneous language decline in early Alzheimer’s disease with a picture description task , 2005, Neurological Sciences.

[6]  Alexandra Konig,et al.  Use of Speech Analyses within a Mobile Application for the Assessment of Cognitive Impairment in Elderly People. , 2018, Current Alzheimer research.

[7]  Marcos Faúndez-Zanuy,et al.  Alzheimer Disease Diagnosis based on Automatic Spontaneous Speech Analysis , 2012, IJCCI.

[8]  Thomas Drugman Residual Excitation Skewness for Automatic Speech Polarity Detection , 2013, IEEE Signal Processing Letters.

[9]  Abeer Alwan,et al.  Joint Robust Voicing Detection and Pitch Estimation Based on Residual Harmonics , 2019, INTERSPEECH.

[10]  Parisa Rashidi,et al.  Deep EHR: A Survey of Recent Advances in Deep Learning Techniques for Electronic Health Record (EHR) Analysis , 2017, IEEE Journal of Biomedical and Health Informatics.

[11]  João Paulo Teixeira,et al.  Algorithm for Jitter and Shimmer Measurement in Pathologic Voices , 2016 .

[12]  F. Martínez-Sánchez,et al.  Speech rhythm alterations in Spanish-speaking individuals with Alzheimer’s disease , 2017, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.

[13]  Brian Roark,et al.  Spoken Language Derived Measures for Detecting Mild Cognitive Impairment , 2011, IEEE Transactions on Audio, Speech, and Language Processing.

[14]  Hélio Magalhães de Oliveira,et al.  Implementation of an Automatic Syllabic Division Algorithm from Speech Files in Portuguese Language , 2015, ArXiv.

[15]  Francisco Martínez-Sánchez,et al.  Acoustic Markers Associated with Impairment in Language Processing in Alzheimer's Disease , 2012, The Spanish journal of psychology.

[16]  Mike Brookes,et al.  Estimation of Glottal Closure Instants in Voiced Speech Using the DYPSA Algorithm , 2007, IEEE Transactions on Audio, Speech, and Language Processing.

[17]  K. Horley,et al.  Emotional prosody perception and production in dementia of the Alzheimer's type. , 2010, Journal of speech, language, and hearing research : JSLHR.

[18]  J M Arana,et al.  Oral reading fluency analysis in patients with Alzheimer disease and asymptomatic control subjects. , 2013, Neurologia.

[19]  Christophe d'Alessandro,et al.  Improved differential phase spectrum processing for formant tracking , 2004, INTERSPEECH.

[20]  Radford M. Neal Pattern Recognition and Machine Learning , 2007, Technometrics.

[21]  Nasser M. Nasrabadi,et al.  Pattern Recognition and Machine Learning , 2006, Technometrics.

[22]  Yiannis Kompatsiaris,et al.  Evaluation of speech-based protocol for detection of early-stage dementia , 2013, INTERSPEECH.

[23]  V. Manera,et al.  Automatic speech analysis for the assessment of patients with predementia and Alzheimer's disease , 2015, Alzheimer's & dementia.

[24]  Dolores E. López,et al.  Speech in Alzheimer's Disease: Can Temporal and Acoustic Parameters Discriminate Dementia? , 2014, Dementia and Geriatric Cognitive Disorders.

[25]  P. Lapuerta,et al.  Impact of early intervention and disease modification in patients with predementia Alzheimer’s disease: a Markov model simulation , 2011, ClinicoEconomics and outcomes research : CEOR.