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Ambrosini E, Giangregorio C, Lomurno E, Moccia S, Milis M, Loizou C, Azzolino D, Cesari M, Cid Gala M, Galán de Isla C, Gomez-Raja J, Borghese NA, Matteucci M, Ferrante S. Automatic Spontaneous Speech Analysis for the Detection of Cognitive Functional Decline in Older Adults: Multilanguage Cross-Sectional Study. JMIR Aging 2024; 7:e50537. [PMID: 38386279 DOI: 10.2196/50537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/18/2023] [Accepted: 02/12/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND The rise in life expectancy is associated with an increase in long-term and gradual cognitive decline. Treatment effectiveness is enhanced at the early stage of the disease. Therefore, there is a need to find low-cost and ecological solutions for mass screening of community-dwelling older adults. OBJECTIVE This work aims to exploit automatic analysis of free speech to identify signs of cognitive function decline. METHODS A sample of 266 participants older than 65 years were recruited in Italy and Spain and were divided into 3 groups according to their Mini-Mental Status Examination (MMSE) scores. People were asked to tell a story and describe a picture, and voice recordings were used to extract high-level features on different time scales automatically. Based on these features, machine learning algorithms were trained to solve binary and multiclass classification problems by using both mono- and cross-lingual approaches. The algorithms were enriched using Shapley Additive Explanations for model explainability. RESULTS In the Italian data set, healthy participants (MMSE score≥27) were automatically discriminated from participants with mildly impaired cognitive function (20≤MMSE score≤26) and from those with moderate to severe impairment of cognitive function (11≤MMSE score≤19) with accuracy of 80% and 86%, respectively. Slightly lower performance was achieved in the Spanish and multilanguage data sets. CONCLUSIONS This work proposes a transparent and unobtrusive assessment method, which might be included in a mobile app for large-scale monitoring of cognitive functionality in older adults. Voice is confirmed to be an important biomarker of cognitive decline due to its noninvasive and easily accessible nature.
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Affiliation(s)
- Emilia Ambrosini
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Chiara Giangregorio
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Eugenio Lomurno
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Sara Moccia
- BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - Christos Loizou
- Department of Electrical Engineering, Computer Engineering and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Domenico Azzolino
- Geriatric Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Matteo Cesari
- Ageing and Health Unit, Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Manuel Cid Gala
- Consejería de Sanidad y Servicios Sociales, Junta de Extremadura, Merida, Spain
| | | | - Jonathan Gomez-Raja
- Consejería de Sanidad y Servicios Sociales, Junta de Extremadura, Merida, Spain
| | | | - Matteo Matteucci
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Simona Ferrante
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
- Laboratory of E-Health Technologies and Artificial Intelligence Research in Neurology, Joint Research Platform, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milano, Italy
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Larrouy-Maestri P, Poeppel D, Pell MD. The Sound of Emotional Prosody: Nearly 3 Decades of Research and Future Directions. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2024:17456916231217722. [PMID: 38232303 DOI: 10.1177/17456916231217722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Emotional voices attract considerable attention. A search on any browser using "emotional prosody" as a key phrase leads to more than a million entries. Such interest is evident in the scientific literature as well; readers are reminded in the introductory paragraphs of countless articles of the great importance of prosody and that listeners easily infer the emotional state of speakers through acoustic information. However, despite decades of research on this topic and important achievements, the mapping between acoustics and emotional states is still unclear. In this article, we chart the rich literature on emotional prosody for both newcomers to the field and researchers seeking updates. We also summarize problems revealed by a sample of the literature of the last decades and propose concrete research directions for addressing them, ultimately to satisfy the need for more mechanistic knowledge of emotional prosody.
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Affiliation(s)
- Pauline Larrouy-Maestri
- Max Planck Institute for Empirical Aesthetics, Frankfurt, Germany
- School of Communication Sciences and Disorders, McGill University
- Max Planck-NYU Center for Language, Music, and Emotion, New York, New York
| | - David Poeppel
- Max Planck-NYU Center for Language, Music, and Emotion, New York, New York
- Department of Psychology and Center for Neural Science, New York University
- Ernst Strüngmann Institute for Neuroscience, Frankfurt, Germany
| | - Marc D Pell
- School of Communication Sciences and Disorders, McGill University
- Centre for Research on Brain, Language, and Music, Montreal, Quebec, Canada
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Rodero E, Mas L, Larrea O, Rodríguez-de-Dios I, de-la-Mota C. The Relevance of Communication Between Alzheimer's Patients and Their Caregivers. Effective Prosody Strategies to Improve Communication. HEALTH COMMUNICATION 2023:1-14. [PMID: 38124466 DOI: 10.1080/10410236.2023.2292830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
One of the most critical factors in Alzheimer's disease (AD) is communication between patients and caregivers. A relevant part of the way of speaking is what is known as prosody, or the variations a speaker makes when talking. To our knowledge, no research has analyzed the relevance of communication for caregivers when speaking with AD patients or what they consider the most effective strategies to communicate with them. Therefore, this pilot study aims are twofold: to know the relevance caregivers (professionals and family) give to communication with AD patients; and to determine what prosody strategies they consider most effective. Two hundred fifty-two caregivers of AD patients (professional and family) participated in two online surveys, answering different questions about the relevance of communication and the best prosody strategies. They also performed an auditory perceptual assessment. The results showed that caregivers give communication a significant role in the patient's treatment behavior. They consider Alzheimer's (AD) patients should be spoken to with authority but with affection and positiveness. The most valued prosodic strategies were marked intonation, speaking affectionately, emphasizing essential words, a medium/low pitch, and a slow speed. This study highlights the value of communication in interacting with AD patients to improve their cognitive and emotional responses.
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Affiliation(s)
- Emma Rodero
- Media Psychology Lab, Department of Communication, Pompeu Fabra University, UPF-Barcelona School of Management, Barcelona, Spain
| | - Lluís Mas
- Department of Communication, Pompeu Fabra University, UPF-Barcelona School of Management, Barcelona, Spain
| | - Olatz Larrea
- Department of Philology and Communication, University of Barcelona, Barcelona, Spain
| | | | - Carme de-la-Mota
- Department of Spanish Philology, Autonomous University of Barcelona, Barcelona, Spain
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Oh C, Morris R, Wang X, Raskin MS. Analysis of emotional prosody as a tool for differential diagnosis of cognitive impairments: a pilot research. Front Psychol 2023; 14:1129406. [PMID: 37425151 PMCID: PMC10327638 DOI: 10.3389/fpsyg.2023.1129406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/26/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction This pilot research was designed to investigate if prosodic features from running spontaneous speech could differentiate dementia of the Alzheimer's type (DAT), vascular dementia (VaD), mild cognitive impairment (MCI), and healthy cognition. The study included acoustic measurements of prosodic features (Study 1) and listeners' perception of emotional prosody differences (Study 2). Methods For Study 1, prerecorded speech samples describing the Cookie Theft picture from 10 individuals with DAT, 5 with VaD, 9 with MCI, and 10 neurologically healthy controls (NHC) were obtained from the DementiaBank. The descriptive narratives by each participant were separated into utterances. These utterances were measured on 22 acoustic features via the Praat software and analyzed statistically using the principal component analysis (PCA), regression, and Mahalanobis distance measures. Results The analyses on acoustic data revealed a set of five factors and four salient features (i.e., pitch, amplitude, rate, and syllable) that discriminate the four groups. For Study 2, a group of 28 listeners served as judges of emotions expressed by the speakers. After a set of training and practice sessions, they were instructed to indicate the emotions they heard. Regression measures were used to analyze the perceptual data. The perceptual data indicated that the factor underlying pitch measures had the greatest strength for the listeners to separate the groups. Discussion The present pilot work showed that using acoustic measures of prosodic features may be a functional method for differentiating among DAT, VaD, MCI, and NHC. Future studies with data collected under a controlled environment using better stimuli are warranted.
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Affiliation(s)
- Chorong Oh
- School of Rehabilitation and Communication Sciences, Ohio University, Athens, OH, United States
| | - Richard Morris
- School of Communication Science and Disorders, Florida State University, Tallahassee, FL, United States
| | - Xianhui Wang
- School of Medicine, University of California Irvine, Irvine, CA, United States
| | - Morgan S. Raskin
- School of Communication Science and Disorders, Florida State University, Tallahassee, FL, United States
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Martínez-Nicolás I, Martínez-Sánchez F, Ivanova O, Meilán JJG. Reading and lexical-semantic retrieval tasks outperforms single task speech analysis in the screening of mild cognitive impairment and Alzheimer's disease. Sci Rep 2023; 13:9728. [PMID: 37322073 PMCID: PMC10272227 DOI: 10.1038/s41598-023-36804-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/12/2023] [Indexed: 06/17/2023] Open
Abstract
Age-related cognitive impairment have increased dramatically in recent years, which has risen the interes in developing screening tools for mild cognitive impairment and Alzheimer's disease. Speech analysis allows to exploit the behavioral consequences of cognitive deficits on the patient's vocal performance so that it is possible to identify pathologies affecting speech production such as dementia. Previous studies have further shown that the speech task used determines how the speech parameters are altered. We aim to combine the impairments in several speech production tasks in order to improve the accuracy of screening through speech analysis. The sample consists of 72 participants divided into three equal groups of healthy older adults, people with mild cognitive impairment, or Alzheimer's disease, matched by age and education. A complete neuropsychological assessment and two voice recordings were performed. The tasks required the participants to read a text, and complete a sentence with semantic information. A stepwise linear discriminant analysis was performed to select speech parameters with discriminative power. The discriminative functions obtained an accuracy of 83.3% in simultaneous classifications of several levels of cognitive impairment. It would therefore be a promising screening tool for dementia.
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Affiliation(s)
| | | | - Olga Ivanova
- Faculty of Philology, University of Salamanca, 37008, Salamanca, Spain
| | - Juan J G Meilán
- Faculty of Psychology, University of Salamanca, 37008, Salamanca, Spain
- Institute of Neuroscience of Castilla y León, 37007, Salamanca, Spain
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Bae M, Seo MG, Ko H, Ham H, Kim KY, Lee JY. The efficacy of memory load on speech-based detection of Alzheimer's disease. Front Aging Neurosci 2023; 15:1186786. [PMID: 37333455 PMCID: PMC10272350 DOI: 10.3389/fnagi.2023.1186786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction The study aims to test whether an increase in memory load could improve the efficacy in detection of Alzheimer's disease and prediction of the Mini-Mental State Examination (MMSE) score. Methods Speech from 45 mild-to-moderate Alzheimer's disease patients and 44 healthy older adults were collected using three speech tasks with varying memory loads. We investigated and compared speech characteristics of Alzheimer's disease across speech tasks to examine the effect of memory load on speech characteristics. Finally, we built Alzheimer's disease classification models and MMSE prediction models to assess the diagnostic value of speech tasks. Results The speech characteristics of Alzheimer's disease in pitch, loudness, and speech rate were observed and the high-memory-load task intensified such characteristics. The high-memory-load task outperformed in AD classification with an accuracy of 81.4% and MMSE prediction with a mean absolute error of 4.62. Discussion The high-memory-load recall task is an effective method for speech-based Alzheimer's disease detection.
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Affiliation(s)
- Minju Bae
- Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul, Republic of Korea
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Myo-Gyeong Seo
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyunwoong Ko
- Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul, Republic of Korea
- Samsung Medical Center, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hyunsun Ham
- Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul, Republic of Korea
| | - Keun You Kim
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun-Young Lee
- Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul, Republic of Korea
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
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Yamada Y, Shinkawa K, Nemoto M, Nemoto K, Arai T. A mobile application using automatic speech analysis for classifying Alzheimer's disease and mild cognitive impairment. COMPUT SPEECH LANG 2023. [DOI: 10.1016/j.csl.2023.101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Amlerova J, Laczó J, Nedelska Z, Laczó M, Vyhnálek M, Zhang B, Sheardova K, Angelucci F, Andel R, Hort J. Emotional prosody recognition is impaired in Alzheimer’s disease. Alzheimers Res Ther 2022; 14:50. [PMID: 35382868 PMCID: PMC8985328 DOI: 10.1186/s13195-022-00989-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 03/10/2022] [Indexed: 11/17/2022]
Abstract
Background The ability to understand emotions is often disturbed in patients with cognitive impairments. Right temporal lobe structures play a crucial role in emotional processing, especially the amygdala, temporal pole (TP), superior temporal sulcus (STS), and anterior cingulate (AC). Those regions are affected in early stages of Alzheimer´s disease (AD). The aim of our study was to evaluate emotional prosody recognition (EPR) in participants with amnestic mild cognitive impairment (aMCI) due to AD, AD dementia patients, and cognitively healthy controls and to measure volumes or thickness of the brain structures involved in this process. In addition, we correlated EPR score to cognitive impairment as measured by MMSE. The receiver operating characteristic (ROC) analysis was used to assess the ability of EPR tests to differentiate the control group from the aMCI and dementia groups. Methods Eighty-nine participants from the Czech Brain Aging Study: 43 aMCI due to AD, 36 AD dementia, and 23 controls, underwent Prosody Emotional Recognition Test. This experimental test included the playback of 25 sentences with neutral meaning each recorded with different emotional prosody (happiness, sadness, fear, disgust, anger). Volume of the amygdala and thickness of the TP, STS, and rostral and caudal parts of AC (RAC and CAC) were measured using FreeSurfer algorithm software. ANCOVA was used to evaluate EPR score differences. ROC analysis was used to assess the ability of EPR test to differentiate the control group from the aMCI and dementia groups. The Pearson’s correlation coefficients were calculated to explore relationships between EPR scores, structural brain measures, and MMSE. Results EPR was lower in the dementia and aMCI groups compared with controls. EPR total score had high sensitivity in distinguishing between not only controls and patients, but also controls and aMCI, controls and dementia, and aMCI and dementia. EPR decreased with disease severity as it correlated with MMSE. There was a significant positive correlation of EPR and thickness of the right TP, STS, and bilateral RAC. Conclusions EPR is impaired in AD dementia and aMCI due to AD. These data suggest that the broad range of AD symptoms may include specific deficits in the emotional sphere which further complicate the patient’s quality of life.
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Logogenic Primary Progressive Aphasia or Alzheimer Disease: Contribution of Acoustic Markers in Early Differential Diagnosis. LIFE (BASEL, SWITZERLAND) 2022; 12:life12070933. [PMID: 35888023 PMCID: PMC9316974 DOI: 10.3390/life12070933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/09/2022] [Accepted: 06/20/2022] [Indexed: 11/22/2022]
Abstract
The logopenic variant of Primary Progressive Aphasia (lvPPA), a syndromic disorder centered on language impairment, often presents variable underlying neurodegenerative pathologies such as Alzheimer Disease (AD). Actual language assessment tests and lumbar puncture, focused on AD diagnosis, cannot precisely distinguish the symptoms, or predict their progression at onset time. We analyzed acoustic markers, aiming to discriminate lvPPA and AD as well as the influence of AD biomarkers on acoustic profiles at the beginning of the disease. We recruited people with AD (n = 8) and with lvPPA (n = 8), with cerebrospinal fluid biomarker profiles determined by lumbar puncture. The participants performed a sentence repetition task that allows assessing potential lvPPA phonological loop deficits. We found that temporal and prosodic markers significantly differentiate the lvPPA and AD group at an early stage of the disease. Biomarker and acoustic profile comparisons discriminated the two lvPPA subgroups according to their biomarkers. For lvPPA with AD biomarkers, acoustic profile equivalent to an atypical AD form with a specific alteration of the phonological loop is shown. However, lvPPA without AD biomarkers has an acoustic profile approximating the one for DLFT. Therefore, these results allow us to classify lvPPA differentially from AD based on acoustic markers from a sentence repetition task. Furthermore, our results suggest that acoustic analysis would constitute a clinically efficient alternative to refused lumbar punctures. It offers the possibility to facilitate early, specific, and accessible neurodegenerative diagnosis and may ease early care with speech therapy, preventing the progression of symptoms.
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Speech- and Language-Based Classification of Alzheimer's Disease: A Systematic Review. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9010027. [PMID: 35049736 PMCID: PMC8772820 DOI: 10.3390/bioengineering9010027] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/25/2021] [Accepted: 11/30/2021] [Indexed: 12/04/2022]
Abstract
Background: Alzheimer’s disease (AD) has paramount importance due to its rising prevalence, the impact on the patient and society, and the related healthcare costs. However, current diagnostic techniques are not designed for frequent mass screening, delaying therapeutic intervention and worsening prognoses. To be able to detect AD at an early stage, ideally at a pre-clinical stage, speech analysis emerges as a simple low-cost non-invasive procedure. Objectives: In this work it is our objective to do a systematic review about speech-based detection and classification of Alzheimer’s Disease with the purpose of identifying the most effective algorithms and best practices. Methods: A systematic literature search was performed from Jan 2015 up to May 2020 using ScienceDirect, PubMed and DBLP. Articles were screened by title, abstract and full text as needed. A manual complementary search among the references of the included papers was also performed. Inclusion criteria and search strategies were defined a priori. Results: We were able: to identify the main resources that can support the development of decision support systems for AD, to list speech features that are correlated with the linguistic and acoustic footprint of the disease, to recognize the data models that can provide robust results and to observe the performance indicators that were reported. Discussion: A computational system with the adequate elements combination, based on the identified best-practices, can point to a whole new diagnostic approach, leading to better insights about AD symptoms and its disease patterns, creating conditions to promote a longer life span as well as an improvement in patient quality of life. The clinically relevant results that were identified can be used to establish a reference system and help to define research guidelines for future developments.
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Steinert L, Putze F, Küster D, Schultz T. Predicting Activation Liking of People With Dementia. FRONTIERS IN COMPUTER SCIENCE 2022. [DOI: 10.3389/fcomp.2021.770492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Physical, social and cognitive activation is an important cornerstone in non-pharmacological therapy for People with Dementia (PwD). To support long-term motivation and well-being, activation contents first need to be perceived positively. Prompting for explicit feedback, however, is intrusive and interrupts the activation flow. Automated analyses of verbal and non-verbal signals could provide an unobtrusive means of recommending suitable contents based on implicit feedback. In this study, we investigate the correlation between engagement responses and self-reported activation ratings. Subsequently, we predict ratings of PwD based on verbal and non-verbal signals in an unconstrained care setting. Applying Long-Short-Term-Memory (LSTM) networks, we can show that our classifier outperforms chance level. We further investigate which features are the most promising indicators for the prediction of activation ratings of PwD.
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12
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Heilman KM, Nadeau SE. Emotional and Neuropsychiatric Disorders Associated with Alzheimer's Disease. Neurotherapeutics 2022; 19:99-116. [PMID: 35013934 PMCID: PMC9130428 DOI: 10.1007/s13311-021-01172-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 01/03/2023] Open
Abstract
Alzheimer's disease is associated with impairments in emotional communication including comprehension and production of facial emotional expressions, comprehension of affective prosody, and alexithymia. It is also associated with disorders of emotional experience including mood disorders (depression and anxiety), agitation/aggression, and psychosis. Agitation/aggression and psychosis are particularly disruptive, are associated with earlier institutionalization, and pose a major challenge to institutional management. Treatment of disorders of emotional experience has been primarily pharmacologic (reviewed here in detail) and has relied heavily on antipsychotic medications despite the small effect sizes demonstrated in a large number of randomized controlled trials and the prevalence of serious side effects associated with these drugs. Recent studies suggest that treatment with pimavanserin, an antipsychotic without activity at dopamine receptors, may represent an important advance for treatment of psychotic manifestations, even as the drug appears to pose significant risk. Dextromethorphan/quinidine may represent an important advance in the treatment of agitation/aggression. There is also compelling evidence that sleep disorders, which are common among patients with Alzheimer's disease and are readily treatable, may potentiate psychotic manifestations and agitation/aggression, but further studies are needed.
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Affiliation(s)
- Kenneth M Heilman
- Geriatric Research, Education, and Clinical Center, Malcom Randall VA Medical Center, 1601 SW Archer Road, Gainesville, FL, 32608-1197, USA
- The Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, 1601 SW Archer Road, Gainesville, FL, 32608-1197, USA
- Malcom Randall VA Medical Center and the Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Stephen E Nadeau
- Research Service, Malcom Randall VA Medical Center, 1601 SW Archer Road, Gainesville, FL, 32608-1197, USA.
- The Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, 1601 SW Archer Road, Gainesville, FL, 32608-1197, USA.
- Malcom Randall VA Medical Center and the Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA.
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Lin Y, Ding H, Zhang Y. Unisensory and Multisensory Stroop Effects Modulate Gender Differences in Verbal and Nonverbal Emotion Perception. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4439-4457. [PMID: 34469179 DOI: 10.1044/2021_jslhr-20-00338] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose This study aimed to examine the Stroop effects of verbal and nonverbal cues and their relative impacts on gender differences in unisensory and multisensory emotion perception. Method Experiment 1 investigated how well 88 normal Chinese adults (43 women and 45 men) could identify emotions conveyed through face, prosody and semantics as three independent channels. Experiments 2 and 3 further explored gender differences during multisensory integration of emotion through a cross-channel (prosody-semantics) and a cross-modal (face-prosody-semantics) Stroop task, respectively, in which 78 participants (41 women and 37 men) were asked to selectively attend to one of the two or three communication channels. Results The integration of accuracy and reaction time data indicated that paralinguistic cues (i.e., face and prosody) of emotions were consistently more salient than linguistic ones (i.e., semantics) throughout the study. Additionally, women demonstrated advantages in processing all three types of emotional signals in the unisensory task, but only preserved their strengths in paralinguistic processing and showed greater Stroop effects of nonverbal cues on verbal ones during multisensory perception. Conclusions These findings demonstrate clear gender differences in verbal and nonverbal emotion perception that are modulated by sensory channels, which have important theoretical and practical implications. Supplemental Material https://doi.org/10.23641/asha.16435599.
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Affiliation(s)
- Yi Lin
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
| | - Hongwei Ding
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
| | - Yang Zhang
- Department of Speech-Language-Hearing Sciences & Center for Neurobehavioral Development, University of Minnesota, Minneapolis
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Oh C, Morris RJ, Wang X. A Systematic Review of Expressive and Receptive Prosody in People With Dementia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3803-3825. [PMID: 34529922 DOI: 10.1044/2021_jslhr-21-00013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose This review was designed to provide a systematic overview of prosody in people with a primary diagnosis of dementia (PwD) and evaluate the potential use of prosodic features for diagnosis of dementia. Method A systematic search of five databases was conducted using Medical Subject Headings and keywords. Studies included in the review were evaluated for their methodological quality using the modified Joanna Briggs Institute checklist. Results A total of 14 articles were identified as being relevant for this review. Among the 14 articles, the methodological quality ranged, with eight rated as weak, four rated as moderate, and two rated as strong. Ten of the 14 articles had people with Alzheimer's disease (AD) as participants, and the remaining four had people with frontotemporal dementia as participants. Four articles focused on receptive prosody, another six focused on expressive prosody, and the remaining four articles were investigations into both. The 14 articles presented inconsistent findings, and various tasks were used to measure prosodic features in PwD in the articles. Prosody was studied as a diagnostic tool for dementia in four of the articles, all of which were based on expressive prosody in individuals with AD. Among the four articles, three proposed the use of automatic speech analysis for diagnosis of AD. Conclusions This review demonstrates that prosody in PwD is an underinvestigated area. In particular, it was concerning that most articles were of weak methodological quality. Nevertheless, it was found that prosody may be a potential diagnostic tool for assessing dementia. More studies that replicate the existing studies and those with stronger methodology are needed to confirm that receptive and/or expressive prosody can be used for dementia diagnosis.
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Affiliation(s)
- Chorong Oh
- School of Rehabilitation and Communication Sciences, Ohio University, Athens
| | - Richard J Morris
- School of Communication Science & Disorders, Florida State University, Tallahassee
| | - Xianhui Wang
- School of Rehabilitation and Communication Sciences, Ohio University, Athens
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Sivasathiaseelan H, Marshall CR, Benhamou E, van Leeuwen JEP, Bond RL, Russell LL, Greaves C, Moore KM, Hardy CJD, Frost C, Rohrer JD, Scott SK, Warren JD. Laughter as a paradigm of socio-emotional signal processing in dementia. Cortex 2021; 142:186-203. [PMID: 34273798 PMCID: PMC8438290 DOI: 10.1016/j.cortex.2021.05.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/01/2021] [Accepted: 05/21/2021] [Indexed: 11/03/2022]
Abstract
Laughter is a fundamental communicative signal in our relations with other people and is used to convey a diverse repertoire of social and emotional information. It is therefore potentially a useful probe of impaired socio-emotional signal processing in neurodegenerative diseases. Here we investigated the cognitive and affective processing of laughter in forty-seven patients representing all major syndromes of frontotemporal dementia, a disease spectrum characterised by severe socio-emotional dysfunction (twenty-two with behavioural variant frontotemporal dementia, twelve with semantic variant primary progressive aphasia, thirteen with nonfluent-agrammatic variant primary progressive aphasia), in relation to fifteen patients with typical amnestic Alzheimer's disease and twenty healthy age-matched individuals. We assessed cognitive labelling (identification) and valence rating (affective evaluation) of samples of spontaneous (mirthful and hostile) and volitional (posed) laughter versus two auditory control conditions (a synthetic laughter-like stimulus and spoken numbers). Neuroanatomical associations of laughter processing were assessed using voxel-based morphometry of patients' brain MR images. While all dementia syndromes were associated with impaired identification of laughter subtypes relative to healthy controls, this was significantly more severe overall in frontotemporal dementia than in Alzheimer's disease and particularly in the behavioural and semantic variants, which also showed abnormal affective evaluation of laughter. Over the patient cohort, laughter identification accuracy was correlated with measures of daily-life socio-emotional functioning. Certain striking syndromic signatures emerged, including enhanced liking for hostile laughter in behavioural variant frontotemporal dementia, impaired processing of synthetic laughter in the nonfluent-agrammatic variant (consistent with a generic complex auditory perceptual deficit) and enhanced liking for numbers ('numerophilia') in the semantic variant. Across the patient cohort, overall laughter identification accuracy correlated with regional grey matter in a core network encompassing inferior frontal and cingulo-insular cortices; and more specific correlates of laughter identification accuracy were delineated in cortical regions mediating affective disambiguation (identification of hostile and posed laughter in orbitofrontal cortex) and authenticity (social intent) decoding (identification of mirthful and posed laughter in anteromedial prefrontal cortex) (all p < .05 after correction for multiple voxel-wise comparisons over the whole brain). These findings reveal a rich diversity of cognitive and affective laughter phenotypes in canonical dementia syndromes and suggest that laughter is an informative probe of neural mechanisms underpinning socio-emotional dysfunction in neurodegenerative disease.
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Affiliation(s)
- Harri Sivasathiaseelan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Charles R Marshall
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Elia Benhamou
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Janneke E P van Leeuwen
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Rebecca L Bond
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Lucy L Russell
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Caroline Greaves
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Katrina M Moore
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Chris J D Hardy
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Chris Frost
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sophie K Scott
- Institute of Cognitive Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jason D Warren
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
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16
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Vincze V, Szatlóczki G, Tóth L, Gosztolya G, Pákáski M, Hoffmann I, Kálmán J. Telltale silence: temporal speech parameters discriminate between prodromal dementia and mild Alzheimer's disease. CLINICAL LINGUISTICS & PHONETICS 2021; 35:727-742. [PMID: 32993390 DOI: 10.1080/02699206.2020.1827043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 09/11/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
This study presents a novel approach for the early detection of mild cognitive impairment (MCI) and mild Alzheimer's disease (mAD) in the elderly. Participants were 25 elderly controls (C), 25 clinically diagnosed MCI and 25 mAD patients, included after a clinical diagnosis validated by CT or MRI and cognitive tests. Our linguistic protocol involved three connected speech tasks that stimulate different memory systems, which were recorded, then analyzed linguistically by using the PRAAT software. The temporal speech-related parameters successfully differentiate MCI from mAD and C, such as speech rate, number and length of pauses, the rate of pause and signal. Parameters pauses/duration and silent pauses/duration linearly decreased among the groups, in other words, the percentage of pauses in the total duration of speech continuously grows as dementia progresses. Thus, the proposed approach may be an effective tool for screening MCI and mAD.
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Affiliation(s)
- Veronika Vincze
- MTA-SZTE Research Group on Artifical Intelligence, Szeged, Hungary
| | | | - László Tóth
- Institute of Informatics, University of Szeged, Szeged, Hungary
| | - Gábor Gosztolya
- MTA-SZTE Research Group on Artifical Intelligence, Szeged, Hungary
| | | | - Ildikó Hoffmann
- Department of Linguistics, University of Szeged, Szeged, Hungary
- Research Institute for Linguistics, Hungarian Academy of Sciences, Budapest, Hungary
| | - János Kálmán
- Department of Psychiatry, University of Szeged, Szeged, Hungary
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17
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Thomas JA, Burkhardt HA, Chaudhry S, Ngo AD, Sharma S, Zhang L, Au R, Hosseini Ghomi R. Assessing the Utility of Language and Voice Biomarkers to Predict Cognitive Impairment in the Framingham Heart Study Cognitive Aging Cohort Data. J Alzheimers Dis 2021; 76:905-922. [PMID: 32568190 DOI: 10.3233/jad-190783] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is a need for fast, accessible, low-cost, and accurate diagnostic methods for early detection of cognitive decline. Dementia diagnoses are usually made years after symptom onset, missing a window of opportunity for early intervention. OBJECTIVE To evaluate the use of recorded voice features as proxies for cognitive function by using neuropsychological test measures and existing dementia diagnoses. METHODS This study analyzed 170 audio recordings, transcripts, and paired neuropsychological test results from 135 participants selected from the Framingham Heart Study (FHS), which includes 97 recordings of cognitively normal participants and 73 recordings of cognitively impaired participants. Acoustic and linguistic features of the voice samples were correlated with cognitive performance measures to verify their association. RESULTS Language and voice features, when combined with demographic variables, performed with an AUC of 0.942 (95% CI 0.929-0.983) in predicting cognitive status. Features with good predictive power included the acoustic features mean spectral slope in the 500-1500 Hz band, variation in the F2 bandwidth, and variation in the Mel-Frequency Cepstral Coefficient (MFCC) 1; the demographic features employment, education, and age; and the text features of number of words, number of compound words, number of unique nouns, and number of proper names. CONCLUSION Several linguistic and acoustic biomarkers show correlations and predictive power with regard to neuropsychological testing results and cognitive impairment diagnoses, including dementia. This initial study paves the way for a follow-up comprehensive study incorporating the entire FHS cohort.
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Affiliation(s)
| | | | | | | | | | | | - Rhoda Au
- Boston University, Boston, MA, USA
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18
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Martínez-Nicolás I, Llorente TE, Martínez-Sánchez F, Meilán JJG. Ten Years of Research on Automatic Voice and Speech Analysis of People With Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review Article. Front Psychol 2021; 12:620251. [PMID: 33833713 PMCID: PMC8021952 DOI: 10.3389/fpsyg.2021.620251] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background: The field of voice and speech analysis has become increasingly popular over the last 10 years, and articles on its use in detecting neurodegenerative diseases have proliferated. Many studies have identified characteristic speech features that can be used to draw an accurate distinction between healthy aging among older people and those with mild cognitive impairment and Alzheimer's disease. Speech analysis has been singled out as a cost-effective and reliable method for detecting the presence of both conditions. In this research, a systematic review was conducted to determine these features and their diagnostic accuracy. Methods: Peer-reviewed literature was located across multiple databases, involving studies that apply new procedures of automatic speech analysis to collect behavioral evidence of linguistic impairments along with their diagnostic accuracy on Alzheimer's disease and mild cognitive impairment. The risk of bias was assessed by using JBI and QUADAS-2 checklists. Results: Thirty-five papers met the inclusion criteria; of these, 11 were descriptive studies that either identified voice features or explored their cognitive correlates, and the rest were diagnostic studies. Overall, the studies were of good quality and presented solid evidence of the usefulness of this technique. The distinctive acoustic and rhythmic features found are gathered. Most studies record a diagnostic accuracy over 88% for Alzheimer's and 80% for mild cognitive impairment. Conclusion: Automatic speech analysis is a promising tool for diagnosing mild cognitive impairment and Alzheimer's disease. The reported features seem to be indicators of the cognitive changes in older people. The specific features and the cognitive changes involved could be the subject of further research.
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Affiliation(s)
- Israel Martínez-Nicolás
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.,Institute of Neuroscience of Castilla y León, University of Salamanca, Salamanca, Spain
| | - Thide E Llorente
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.,Institute of Neuroscience of Castilla y León, University of Salamanca, Salamanca, Spain
| | | | - Juan José G Meilán
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.,Institute of Neuroscience of Castilla y León, University of Salamanca, Salamanca, Spain
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19
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Walker G, Morris LA, Christensen H, Mirheidari B, Reuber M, Blackburn DJ. Characterising spoken responses to an intelligent virtual agent by persons with mild cognitive impairment. CLINICAL LINGUISTICS & PHONETICS 2021; 35:237-252. [PMID: 32552087 DOI: 10.1080/02699206.2020.1777586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/27/2020] [Accepted: 05/31/2020] [Indexed: 06/11/2023]
Abstract
The diagnosis of Mild Cognitive Impairment (MCI) characterises patients at risk of dementia and may provide an opportunity for disease-modifying interventions. Identifying persons with MCI (PwMCI) from adults of a similar age without cognitive complaints is a significant challenge. The main aims of this study were to determine whether generic speech differences were evident between PwMCI and healthy controls (HC), whether such differences were identifiable in responses to recent or remote memory questions, and to determine which speech variables showed the clearest between-group differences. This study analysed recordings of 8 PwMCI (5 females, 3 males) and 14 HC of a similar age (8 females, 6 males). Participants were recorded interacting with an intelligent virtual agent: a computer-generated talking head on a computer screen which asks pre-recorded questions when prompted by the interviewee through pressing the next key on a computer keyboard. Responses to recent and remote memory questions were analysed. Mann-Whitney U tests were used to test for statistically significant differences between PwMCI and HC on each of 12 speech variables, relating to temporal characteristics, number of words produced and pitch. It was found that compared to HC, PwMCI produce speech for less time and in shorter chunks, they pause more often and for longer, take longer to begin speaking and produce fewer words in their answers. It was also found that the PwMCI and HC were more alike when responding to remote memory questions than when responding to recent memory questions. These findings show great promise and suggest that detailed speech analysis can make an important contribution to diagnostic and stratification systems in patients with memory complaints.
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Affiliation(s)
- Gareth Walker
- School of English, University of Sheffield , Sheffield, UK
| | - Lee-Anne Morris
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield , Sheffield, UK
| | - Heidi Christensen
- Department of Computer Science, University of Sheffield , Sheffield, UK
| | - Bahman Mirheidari
- Department of Computer Science, University of Sheffield , Sheffield, UK
| | - Markus Reuber
- Academic Neurology Unit, Royal Hallamshire Hospital, University of Sheffield , Sheffield, UK
| | - Daniel J Blackburn
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield , Sheffield, UK
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20
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Lin H, Karjadi C, Ang TFA, Prajakta J, McManus C, Alhanai TW, Glass J, Au R. Identification of digital voice biomarkers for cognitive health. EXPLORATION OF MEDICINE 2020; 1:406-417. [PMID: 33665648 PMCID: PMC7929495 DOI: 10.37349/emed.2020.00028] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/04/2020] [Indexed: 01/03/2023] Open
Abstract
AIM Human voice contains rich information. Few longitudinal studies have been conducted to investigate the potential of voice to monitor cognitive health. The objective of this study is to identify voice biomarkers that are predictive of future dementia. METHODS Participants were recruited from the Framingham Heart Study. The vocal responses to neuropsychological tests were recorded, which were then diarized to identify participant voice segments. Acoustic features were extracted with the OpenSMILE toolkit (v2.1). The association of each acoustic feature with incident dementia was assessed by Cox proportional hazards models. RESULTS Our study included 6, 528 voice recordings from 4, 849 participants (mean age 63 ± 15 years old, 54.6% women). The majority of participants (71.2%) had one voice recording, 23.9% had two voice recordings, and the remaining participants (4.9%) had three or more voice recordings. Although all asymptomatic at the time of examination, participants who developed dementia tended to have shorter segments than those who were dementia free (P < 0.001). Additionally, 14 acoustic features were significantly associated with dementia after adjusting for multiple testing (P < 0.05/48 = 1 × 10-3). The most significant acoustic feature was jitterDDP_sma_de (P = 7.9 × 10-7), which represents the differential frame-to-frame Jitter. A voice based linear classifier was also built that was capable of predicting incident dementia with area under curve of 0.812. CONCLUSIONS Multiple acoustic and linguistic features are identified that are associated with incident dementia among asymptomatic participants, which could be used to build better prediction models for passive cognitive health monitoring.
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Affiliation(s)
- Honghuang Lin
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
| | - Cody Karjadi
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Ting F. A. Ang
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
- Slone Epidemiology Center, Boston University School of Medicine, Boston, MA 02118, USA
| | - Joshi Prajakta
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Chelsea McManus
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Tuka W. Alhanai
- Department of Electrical and Computer Engineering, New York University Abu Dhabi, Abu Dhabi, UAE
| | - James Glass
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Rhoda Au
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
- Slone Epidemiology Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
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21
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Themistocleous C, Eckerström M, Kokkinakis D. Voice quality and speech fluency distinguish individuals with Mild Cognitive Impairment from Healthy Controls. PLoS One 2020; 15:e0236009. [PMID: 32658934 PMCID: PMC7357785 DOI: 10.1371/journal.pone.0236009] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/27/2020] [Indexed: 11/19/2022] Open
Abstract
Mild Cognitive Impairment (MCI) is a syndrome characterized by cognitive decline greater than expected for an individual's age and education level. This study aims to determine whether voice quality and speech fluency distinguish patients with MCI from healthy individuals to improve diagnosis of patients with MCI. We analyzed recordings of the Cookie Theft picture description task produced by 26 patients with MCI and 29 healthy controls from Sweden and calculated measures of voice quality and speech fluency. The results show that patients with MCI differ significantly from HC with respect to acoustic aspects of voice quality, namely H1-A3, cepstral peak prominence, center of gravity, and shimmer; and speech fluency, namely articulation rate and averaged speaking time. The method proposed along with the obtainability of connected speech productions can enable quick and easy analysis of speech fluency and voice quality, providing accessible and objective diagnostic markers of patients with MCI.
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Affiliation(s)
| | - Marie Eckerström
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Dimitrios Kokkinakis
- Department of Swedish, University of Gothenburg, Gothenburg, Sweden
- Center of Ageing and Health—AgeCap, University of Gothenburg, Gothenburg, Sweden
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22
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Wisler AA, Fletcher AR, McAuliffe MJ. Predicting Montreal Cognitive Assessment Scores From Measures of Speech and Language. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:1752-1761. [PMID: 32459131 DOI: 10.1044/2020_jslhr-19-00183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This study examined the relationship between measurements derived from spontaneous speech and participants' scores on the Montreal Cognitive Assessment. Method Participants (N = 521) aged between 64 and 97 years completed the cognitive assessment and were prompted to describe an early childhood memory. A range of acoustic and linguistic measures was extracted from the resulting speech sample. A least absolute shrinkage and selection operator approach was used to model the relationship between acoustic, lexical, and demographic information and participants' scores on the cognitive assessment. Results Using the covariance test statistic, four important variables were identified, which, together, explained 16.52% of the variance in participants' cognitive scores. Conclusions The degree to which cognition can be accurately predicted through spontaneously produced speech samples is limited. Statistically significant relationships were found between specific measurements of lexical variation, participants' speaking rate, and their scores on the Montreal Cognitive Assessment.
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Affiliation(s)
- Alan A Wisler
- New Zealand Institute of Language, Brain and Behaviour, Christchurch, New Zealand
| | - Annalise R Fletcher
- Department of Audiology and Speech-Language Pathology, University of North Texas, Denton
| | - Megan J McAuliffe
- Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand
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23
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Ambrosini E, Cid M, de Isla CG, Salamanca P, Borghese NA, Ferrante S, Caielli M, Milis M, Loizou C, Azzolino D, Damanti S, Bertagnoli L, Cesari M, Moccia S. Automatic speech analysis to early detect functional cognitive decline in elderly population. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:212-216. [PMID: 31945880 DOI: 10.1109/embc.2019.8856768] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
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.
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24
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de la Fuente Garcia S, Ritchie CW, Luz S. Artificial Intelligence, Speech, and Language Processing Approaches to Monitoring Alzheimer's Disease: A Systematic Review. J Alzheimers Dis 2020; 78:1547-1574. [PMID: 33185605 PMCID: PMC7836050 DOI: 10.3233/jad-200888] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Language is a valuable source of clinical information in Alzheimer's disease, as it declines concurrently with neurodegeneration. Consequently, speech and language data have been extensively studied in connection with its diagnosis. OBJECTIVE Firstly, to summarize the existing findings on the use of artificial intelligence, speech, and language processing to predict cognitive decline in the context of Alzheimer's disease. Secondly, to detail current research procedures, highlight their limitations, and suggest strategies to address them. METHODS Systematic review of original research between 2000 and 2019, registered in PROSPERO (reference CRD42018116606). An interdisciplinary search covered six databases on engineering (ACM and IEEE), psychology (PsycINFO), medicine (PubMed and Embase), and Web of Science. Bibliographies of relevant papers were screened until December 2019. RESULTS From 3,654 search results, 51 articles were selected against the eligibility criteria. Four tables summarize their findings: study details (aim, population, interventions, comparisons, methods, and outcomes), data details (size, type, modalities, annotation, balance, availability, and language of study), methodology (pre-processing, feature generation, machine learning, evaluation, and results), and clinical applicability (research implications, clinical potential, risk of bias, and strengths/limitations). CONCLUSION Promising results are reported across nearly all 51 studies, but very few have been implemented in clinical research or practice. The main limitations of the field are poor standardization, limited comparability of results, and a degree of disconnect between study aims and clinical applications. Active attempts to close these gaps will support translation of future research into clinical practice.
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Affiliation(s)
| | - Craig W. Ritchie
- Centre for Clinical Brain Sciences, The University of Edinburgh, Scotland, UK
| | - Saturnino Luz
- Usher Institute, Edinburgh Medical School, The University of Edinburgh, Scotland, UK
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25
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Arroyo-Anlló EM, Dauphin S, Fargeau MN, Ingrand P, Gil R. Music and emotion in Alzheimer's disease. Alzheimers Res Ther 2019; 11:69. [PMID: 31391062 PMCID: PMC6686394 DOI: 10.1186/s13195-019-0523-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 07/22/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Alzheimer's disease may compromise several musical competences, though no clear data is available in the scientific literature. Furthermore, music is capable of communicating basic emotions, but little is known about the emotional aspect of music in patients with Alzheimer's disease. We present a systematic investigation of music processing in relation to extra-musical skills, in particular emotional skills in patients with Alzheimer's disease. METHODS We tested 30 patients with mild or moderate Alzheimer's disease and 30 control subjects. We essentially evaluated (a) musical competences, using the extra-linguistic test, Solfeggio test and the recognition test of musical emotions-elaborated by our research team-and the Seashore test, and (b) emotional capacities using emotional memory and emotional prosody tests-made by our research group. RESULTS We significantly observed lower total results of every test assessing cognitive, emotional and music competences in Alzheimer's disease patients than those in control subjects, but the score of musical emotion recognition test did not reach to a significant difference between the subjects groups. CONCLUSIONS Our findings found a global impairment of music competences in Alzheimer patients with cognitive and emotional troubles. Nevertheless, the performances in the recognition test of musical emotions showed a trend towards a performance difference. We can suggest that Alzheimer's disease currently presents an aphaso-agnoso-apractic-amusia syndrome.
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Affiliation(s)
- Eva M. Arroyo-Anlló
- Department of Psychobiology, Neuroscience Institute of Castilla-León, University of Salamanca, Av. de la Merced s/n 37007, Salamanca, Spain
- Emeriti Professor of Neurology, University Hospital, Poitiers, France
| | - Stéphanie Dauphin
- Department of Neurology Faculty of Medicine, University Hospital, CHU La Milétrie, 2, Rue de la Milétrie, 86021 Poitiers, France
| | - M. Noelle Fargeau
- Department of Neurology Faculty of Medicine, University Hospital, CHU La Milétrie, 2, Rue de la Milétrie, 86021 Poitiers, France
| | - Pierre Ingrand
- Department of Biostatistics Faculty of Medicine, University of Poitiers, 2, Rue de la Milétrie, 86021 Poitiers, France
| | - Roger Gil
- Emeriti Professor of Neurology, University Hospital, Poitiers, France
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26
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Ray PP, Dash D, De D. A Systematic Review and Implementation of IoT-Based Pervasive Sensor-Enabled Tracking System for Dementia Patients. J Med Syst 2019; 43:287. [PMID: 31317281 DOI: 10.1007/s10916-019-1417-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/08/2019] [Indexed: 01/06/2023]
Abstract
In today's world, 46.8 million people suffer from brain related diseases. Dementia is most prevalent of all. In general scenario, a dementia patient lacks proper guidance in searching out the way to return back at his/her home. Thus, increasing the risk of getting damaged at individual-health level. Therefore, it is important to track their movement in more sophisticated manner as possible. With emergence of wearables, GPS sensors and Internet of Things (IoT), such devices have become available in public domain. Smartphone apps support caregiver to locate the dementia patients in real-time. RF, GSM, 3G, Wi-Fi and 4G technology fill the communication gap between patient and caregiver to bring them closer. In this paper, we incorporated 7 most popular wearables for investigation to seek appropriateness for dementia tracking in recent times in systematic manners. We performed an in-depth review of these wearables as per the cost, technology wise and application wise characteristics. A case novel study i.e. IoT-based Force Sensor Resistance enabled System-FSRIoT, has been proposed and implemented to validate the effectiveness of IoT in the domain of smarter dementia patient tracking in wearable form factor. The results show promising aspect of a whole new notion to leverage efficient assistive physio-medical healthcare to the dementia patients and the affected family members to reduce life risks and achieve a better social life.
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Affiliation(s)
- Partha Pratim Ray
- Department of Computer Applications, Sikkim University, Gangtok, India.
| | - Dinesh Dash
- Department of Computer Science and Engineering, NIT Patna, Patna, India
| | - Debashis De
- Department of Computer Science and Engineering, MAKAUT, Kolkata, India
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Martínez-Sánchez F, Meilán JJG, Carro J, Ivanova O. A Prototype for the Voice Analysis Diagnosis of Alzheimer's Disease. J Alzheimers Dis 2019; 64:473-481. [PMID: 29914025 DOI: 10.3233/jad-180037] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Speech variations enable us to map the performance of cognitive processes of syntactic, semantic, phonological, and articulatory planning and execution. Speaking is one of the first functions to be affected by neurodegenerative complaints such as Alzheimer's disease (AD), which makes the speech a highly promising biomarker for detecting the illness before the first preclinical symptoms appear. OBJECTIVE This paper has sought to develop and validate a technological prototype that adopts an automated approach to speech analysis among older people. METHODS It uses a mathematical algorithm based on certain discriminatory variables to estimate the probability of developing AD. RESULTS AND CONCLUSION This device may be used at a preclinical stage by non-expert health professionals to determine the likelihood of the onset of AD.
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Affiliation(s)
| | | | - Juan Carro
- Psychology Faculty, University of Salamanca, Salamanca, Spain
| | - Olga Ivanova
- Philology Faculty, University of Extremadura, Cáceres, Spain
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Dourado MCN, Torres Mendonça de Melo Fádel B, Simões Neto JP, Alves G, Alves C. Facial Expression Recognition Patterns in Mild and Moderate Alzheimer’s Disease. J Alzheimers Dis 2019; 69:539-549. [DOI: 10.3233/jad-181101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
| | | | - José Pedro Simões Neto
- Department of Sociology and Political Science, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Gilberto Alves
- Post Graduation in Psychiatry and Mental Health (PROPSAM), Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
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Beltrami D, Gagliardi G, Rossini Favretti R, Ghidoni E, Tamburini F, Calzà L. Speech Analysis by Natural Language Processing Techniques: A Possible Tool for Very Early Detection of Cognitive Decline? Front Aging Neurosci 2018; 10:369. [PMID: 30483116 PMCID: PMC6243042 DOI: 10.3389/fnagi.2018.00369] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/24/2018] [Indexed: 11/23/2022] Open
Abstract
Background: The discovery of early, non-invasive biomarkers for the identification of “preclinical” or “pre-symptomatic” Alzheimer's disease and other dementias is a key issue in the field, especially for research purposes, the design of preventive clinical trials, and drafting population-based health care policies. Complex behaviors are natural candidates for this. In particular, recent studies have suggested that speech alterations might be one of the earliest signs of cognitive decline, frequently noticeable years before other cognitive deficits become apparent. Traditional neuropsychological language tests provide ambiguous results in this context. In contrast, the analysis of spoken language productions by Natural Language Processing (NLP) techniques can pinpoint language modifications in potential patients. This interdisciplinary study aimed at using NLP to identify early linguistic signs of cognitive decline in a population of elderly individuals. Methods: We enrolled 96 participants (age range 50–75): 48 healthy controls (CG) and 48 cognitively impaired participants: 16 participants with single domain amnestic Mild Cognitive Impairment (aMCI), 16 with multiple domain MCI (mdMCI) and 16 with early Dementia (eD). Each subject underwent a brief neuropsychological screening composed by MMSE, MoCA, GPCog, CDT, and verbal fluency (phonemic and semantic). The spontaneous speech during three tasks (describing a complex picture, a typical working day and recalling a last remembered dream) was then recorded, transcribed and annotated at various linguistic levels. A multidimensional parameter computation was performed by a quantitative analysis of spoken texts, computing rhythmic, acoustic, lexical, morpho-syntactic, and syntactic features. Results: Neuropsychological tests showed significant differences between controls and mdMCI, and between controls and eD participants; GPCog, MoCA, PF, and SF also discriminated between controls and aMCI. In the linguistic experiments, a number of features regarding lexical, acoustic and syntactic aspects were significant in differentiating between mdMCI, eD, and CG (non-parametric statistical analysis). Some features, mainly in the acoustic domain also discriminated between CG and aMCI. Conclusions: Linguistic features of spontaneous speech transcribed and analyzed by NLP techniques show significant differences between controls and pathological states (not only eD but also MCI) and seems to be a promising approach for the identification of preclinical stages of dementia. Long duration follow-up studies are needed to confirm this assumption.
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Affiliation(s)
- Daniela Beltrami
- Interdepartmental Centre for Industrial Research in Health Sciences and Technologies, University of Bologna, Bologna, Italy.,Clinical Neuropsychology Unit, Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia, Italy
| | - Gloria Gagliardi
- Interdepartmental Centre for Industrial Research in Health Sciences and Technologies, University of Bologna, Bologna, Italy.,Department of Classical Philology and Italian Studies, University of Bologna, Bologna, Italy
| | - Rema Rossini Favretti
- Department of Classical Philology and Italian Studies, University of Bologna, Bologna, Italy
| | - Enrico Ghidoni
- Clinical Neuropsychology Unit, Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia, Italy
| | - Fabio Tamburini
- Department of Classical Philology and Italian Studies, University of Bologna, Bologna, Italy
| | - Laura Calzà
- Interdepartmental Centre for Industrial Research in Health Sciences and Technologies, University of Bologna, Bologna, Italy.,Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
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Tanaka H, Adachi H, Ukita N, Ikeda M, Kazui H, Kudo T, Nakamura S. Detecting Dementia Through Interactive Computer Avatars. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2017; 5:2200111. [PMID: 29018636 PMCID: PMC5630006 DOI: 10.1109/jtehm.2017.2752152] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/13/2017] [Accepted: 09/01/2017] [Indexed: 11/07/2022]
Abstract
This paper proposes a new approach to automatically detect dementia. Even though some works have detected dementia from speech and language attributes, most have applied detection using picture descriptions, narratives, and cognitive tasks. In this paper, we propose a new computer avatar with spoken dialog functionalities that produces spoken queries based on the mini-mental state examination, the Wechsler memory scale-revised, and other related neuropsychological questions. We recorded the interactive data of spoken dialogues from 29 participants (14 dementia and 15 healthy controls) and extracted various audiovisual features. We tried to predict dementia using audiovisual features and two machine learning algorithms (support vector machines and logistic regression). Here, we show that the support vector machines outperformed logistic regression, and by using the extracted features they classified the participants into two groups with 0.93 detection performance, as measured by the areas under the receiver operating characteristic curve. We also newly identified some contributing features, e.g., gap before speaking, the variations of fundamental frequency, voice quality, and the ratio of smiling. We concluded that our system has the potential to detect dementia through spoken dialog systems and that the system can assist health care workers. In addition, these findings could help medical personnel detect signs of dementia.
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Affiliation(s)
- Hiroki Tanaka
- Graduate School of Information ScienceNara Institute of Science and Technology
| | | | - Norimichi Ukita
- Graduate School of EngineeringToyota Technological Institute
| | - Manabu Ikeda
- Department of PsychiatryGraduate School of MedicineOsaka University
| | - Hiroaki Kazui
- Department of PsychiatryGraduate School of MedicineOsaka University
| | | | - Satoshi Nakamura
- Graduate School of Information ScienceNara Institute of Science and Technology
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Arroyo-Anlló EM, Chamorro Sánchez J, Ortiz Oria VM, Gil R. Consciencia del otro en patologías neurodegenerativas. REVISTA LATINOAMERICANA DE PSICOLOGIA 2017. [DOI: 10.1016/j.rlp.2015.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hardy CJD, Marshall CR, Golden HL, Clark CN, Mummery CJ, Griffiths TD, Bamiou DE, Warren JD. Hearing and dementia. J Neurol 2016; 263:2339-2354. [PMID: 27372450 PMCID: PMC5065893 DOI: 10.1007/s00415-016-8208-y] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/13/2016] [Accepted: 06/14/2016] [Indexed: 02/04/2023]
Abstract
Hearing deficits associated with cognitive impairment have attracted much recent interest, motivated by emerging evidence that impaired hearing is a risk factor for cognitive decline. However, dementia and hearing impairment present immense challenges in their own right, and their intersection in the auditory brain remains poorly understood and difficult to assess. Here, we outline a clinically oriented, symptom-based approach to the assessment of hearing in dementias, informed by recent progress in the clinical auditory neuroscience of these diseases. We consider the significance and interpretation of hearing loss and symptoms that point to a disorder of auditory cognition in patients with dementia. We identify key auditory characteristics of some important dementias and conclude with a bedside approach to assessing and managing auditory dysfunction in dementia.
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Affiliation(s)
- Chris J D Hardy
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Charles R Marshall
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Hannah L Golden
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Camilla N Clark
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
| | - Catherine J Mummery
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
- Cognitive Disorders Clinic for the Deaf, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Timothy D Griffiths
- Auditory Group, Institute of Neuroscience, The Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
- Central Auditory Disorders Clinic, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Doris-Eva Bamiou
- Department of Neuro-otology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- UCL Ear Institute, University College London, London, UK
- Central Auditory Disorders Clinic, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Jason D Warren
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK.
- Central Auditory Disorders Clinic, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
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Abstract
BACKGROUND There is growing awareness that the subjective experience of people with dementia is important for understanding behavior and improving quality of life. This paper reviews and reflects on the currently available theories on subjective experience in dementia and it explores the possibility of a knowledge gap on the influence of neurological deficits on experience in late stage dementia. METHODS A literature review on current commonly used theories on experience in dementia was supplemented with a systematic review in PubMed and Psychinfo. For the systematic review, the terms used were Perception and Dementia and Behavior; and Awareness and Dementia and Long term care. RESULTS Current models emphasize the psychosocial factors that influence subjective experience, but the consequences of neurological deficits are not elaborated upon. The systematic literature search on the neuropsychological functioning in dementia resulted in 631 papers, of which 94 were selected for review. The current knowledge is limited to the early stages of Alzheimer's disease. Next to memory impairments, perception of the direct environment, interpretation of the environment, and inhibition of own responses to the environment seem to be altered in people with dementia. CONCLUSIONS Without knowledge on how perception, interpretation and the ability for response control are altered, the behavior of people with dementia can easily be misinterpreted. Research into neuropsychological functioning of people in more severe stages and different forms of dementia is needed to be able to develop a model that is truly biopsychosocial. The proposed model can be used in such research as a starting point for developing tests and theories.
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Mekyska J, Janousova E, Gomez-Vilda P, Smekal Z, Rektorova I, Eliasova I, Kostalova M, Mrackova M, Alonso-Hernandez JB, Faundez-Zanuy M, López-de-Ipiña K. Robust and complex approach of pathological speech signal analysis. Neurocomputing 2015. [DOI: 10.1016/j.neucom.2015.02.085] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Dupuis K, Pichora-Fuller MK. Aging Affects Identification of Vocal Emotions in Semantically Neutral Sentences. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2015; 58:1061-1076. [PMID: 25810032 DOI: 10.1044/2015_jslhr-h-14-0256] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 03/10/2015] [Indexed: 06/04/2023]
Abstract
PURPOSE The authors determined the accuracy of younger and older adults in identifying vocal emotions using the Toronto Emotional Speech Set (TESS; Dupuis & Pichora-Fuller, 2010a) and investigated the possible contributions of auditory acuity and suprathreshold processing to emotion identification accuracy. METHOD In 2 experiments, younger and older adults with normal hearing listened to and identified vocal emotions in the TESS stimuli. The TESS consists of phrases with controlled syntactic, lexical, and phonological properties spoken by an older female talker and a younger female talker to convey 7 emotion conditions (anger, disgust, fear, sadness, neutral, happiness, and pleasant surprise). Participants in both experiments completed audiometric testing; participants in Experiment 2 also completed 3 tests of suprathreshold auditory processing. RESULTS Identification by both age groups was above chance for all emotions. Accuracy was lower for older adults in both experiments. The pattern of results was similar across age groups and experiments. Auditory acuity did not predict identification accuracy for either age group in either experiment, nor did performance on tests of auditory processing in Experiment 2. CONCLUSIONS These results replicate and extend previous findings concerning age-related differences in ability to identify vocal emotions and suggest that older adults' auditory abilities do not explain their difficulties in identifying vocal emotions.
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König A, Satt A, Sorin A, Hoory R, Toledo-Ronen O, Derreumaux A, Manera V, Verhey F, Aalten P, Robert PH, David R. Automatic speech analysis for the assessment of patients with predementia and Alzheimer's disease. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2015; 1:112-24. [PMID: 27239498 PMCID: PMC4876915 DOI: 10.1016/j.dadm.2014.11.012] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background To evaluate the interest of using automatic speech analyses for the assessment of mild cognitive impairment (MCI) and early-stage Alzheimer's disease (AD). Methods Healthy elderly control (HC) subjects and patients with MCI or AD were recorded while performing several short cognitive vocal tasks. The voice recordings were processed, and the first vocal markers were extracted using speech signal processing techniques. Second, the vocal markers were tested to assess their “power” to distinguish among HC, MCI, and AD. The second step included training automatic classifiers for detecting MCI and AD, using machine learning methods and testing the detection accuracy. Results The classification accuracy of automatic audio analyses were as follows: between HCs and those with MCI, 79% ± 5%; between HCs and those with AD, 87% ± 3%; and between those with MCI and those with AD, 80% ± 5%, demonstrating its assessment utility. Conclusion Automatic speech analyses could be an additional objective assessment tool for elderly with cognitive decline.
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Affiliation(s)
- Alexandra König
- Research Unit CoBTeK - Cognition Behaviour Technology, Edmond & Lily Safra Research Center, University of Nice Sophia Antipolis, Nice, France; Alzheimer Centre Limburg, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Aharon Satt
- Speech Technologies, IBM Research, Haifa, Israel
| | | | - Ron Hoory
- Speech Technologies, IBM Research, Haifa, Israel
| | | | - Alexandre Derreumaux
- Research Unit CoBTeK - Cognition Behaviour Technology, Edmond & Lily Safra Research Center, University of Nice Sophia Antipolis, Nice, France
| | - Valeria Manera
- Research Unit CoBTeK - Cognition Behaviour Technology, Edmond & Lily Safra Research Center, University of Nice Sophia Antipolis, Nice, France
| | - Frans Verhey
- Alzheimer Centre Limburg, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Pauline Aalten
- Alzheimer Centre Limburg, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Phillipe H Robert
- Research Unit CoBTeK - Cognition Behaviour Technology, Edmond & Lily Safra Research Center, University of Nice Sophia Antipolis, Nice, France; Centre Mémoire de Ressources et de Recherche, CHU de Nice, Nice, France
| | - Renaud David
- Research Unit CoBTeK - Cognition Behaviour Technology, Edmond & Lily Safra Research Center, University of Nice Sophia Antipolis, Nice, France; Centre Mémoire de Ressources et de Recherche, CHU de Nice, Nice, France
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Meilán JJG, Martínez-Sánchez F, Carro J, López DE, Millian-Morell L, Arana JM. Speech in Alzheimer's disease: can temporal and acoustic parameters discriminate dementia? Dement Geriatr Cogn Disord 2015; 37:327-34. [PMID: 24481220 DOI: 10.1159/000356726] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/15/2013] [Indexed: 11/19/2022] Open
Abstract
AIMS The study explores how speech measures may be linked to language profiles in participants with Alzheimer's disease (AD) and how these profiles could distinguish AD from changes associated with normal aging. METHODS We analysed simple sentences spoken by older adults with and without AD. Spectrographic analysis of temporal and acoustic characteristics was carried out using the Praat software. RESULTS We found that measures of speech, such as variations in the percentage of voice breaks, number of periods of voice, number of voice breaks, shimmer (amplitude perturbation quotient), and noise-to-harmonics ratio, characterise people with AD with an accuracy of 84.8%. DISCUSSION These measures offer a sensitive method of assessing spontaneous speech output in AD, and they discriminate well between people with AD and healthy older adults. This method of evaluation is a promising tool for AD diagnosis and prognosis, and it could be used as a dependent measure in clinical trials.
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Affiliation(s)
- Juan José G Meilán
- Institute of Neurosciences of Castilla y León, University of Salamanca, Salamanca, Spain
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López-de-Ipiña K, Alonso-Hernández J, Solé-Casals J, Travieso-González C, Ezeiza A, Faúndez-Zanuy M, Calvo P, Beitia B. Feature selection for automatic analysis of emotional response based on nonlinear speech modeling suitable for diagnosis of Alzheimer׳s disease. Neurocomputing 2015. [DOI: 10.1016/j.neucom.2014.05.083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Innovative diagnostic tools for early detection of Alzheimer's disease. Alzheimers Dement 2014; 11:561-78. [PMID: 25443858 DOI: 10.1016/j.jalz.2014.06.004] [Citation(s) in RCA: 155] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 04/21/2014] [Accepted: 06/16/2014] [Indexed: 02/06/2023]
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On Automatic Diagnosis of Alzheimer’s Disease Based on Spontaneous Speech Analysis and Emotional Temperature. Cognit Comput 2013. [DOI: 10.1007/s12559-013-9229-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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López-de-Ipiña K, Alonso JB, Travieso CM, Solé-Casals J, Egiraun H, Faundez-Zanuy M, Ezeiza A, Barroso N, Ecay-Torres M, Martinez-Lage P, de Lizardui UM. On the selection of non-invasive methods based on speech analysis oriented to automatic Alzheimer disease diagnosis. SENSORS (BASEL, SWITZERLAND) 2013; 13:6730-45. [PMID: 23698268 PMCID: PMC3690078 DOI: 10.3390/s130506730] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 05/08/2013] [Accepted: 05/13/2013] [Indexed: 11/16/2022]
Abstract
The work presented here is part of a larger study to identify novel technologies and biomarkers for early Alzheimer disease (AD) detection and it focuses on evaluating the suitability of a new approach for early AD diagnosis by non-invasive methods. The purpose is to examine in a pilot study the potential of applying intelligent algorithms to speech features obtained from suspected patients in order to contribute to the improvement of diagnosis of AD and its degree of severity. In this sense, Artificial Neural Networks (ANN) have been used for the automatic classification of the two classes (AD and control subjects). Two human issues have been analyzed for feature selection: Spontaneous Speech and Emotional Response. Not only linear features but also non-linear ones, such as Fractal Dimension, have been explored. The approach is non invasive, low cost and without any side effects. Obtained experimental results were very satisfactory and promising for early diagnosis and classification of AD patients.
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Affiliation(s)
- Karmele López-de-Ipiña
- Systems Engineering and Automation Department, University of the Basque Country UPV/EHU, Donostia 20018, Spain; E-Mails: (H.E.); (A.E.); (N.B.); (U.M.L.)
| | - Jesus-Bernardino Alonso
- Signal and Communication Departament (DSC), Institute for Technological Development and Innovation in Communications (IDeTIC), University of Las Palmas de Gran Canaria (ULPGC), Campus of Tafira, Las Palmas de Gran Canaria 35017, Spain; E-Mails: (J.-B.A.); (C.M.T.)
| | - Carlos Manuel Travieso
- Signal and Communication Departament (DSC), Institute for Technological Development and Innovation in Communications (IDeTIC), University of Las Palmas de Gran Canaria (ULPGC), Campus of Tafira, Las Palmas de Gran Canaria 35017, Spain; E-Mails: (J.-B.A.); (C.M.T.)
| | - Jordi Solé-Casals
- Digital Technologies Group, University of Vic, Sagrada família 7, Vic 08500, Spain; E-Mail:
| | - Harkaitz Egiraun
- Systems Engineering and Automation Department, University of the Basque Country UPV/EHU, Donostia 20018, Spain; E-Mails: (H.E.); (A.E.); (N.B.); (U.M.L.)
- Research Center for Experimental Marine Biology and Biotechnology, Plentzia Marine Station, University of the Basque Country, Plentzia 48620, Spain
| | - Marcos Faundez-Zanuy
- Escola Universitaria Politècnica de Mataró (UPC), Tecnocampus, Mataró, Barcelona 08302, Spain; E-Mail:
| | - Aitzol Ezeiza
- Systems Engineering and Automation Department, University of the Basque Country UPV/EHU, Donostia 20018, Spain; E-Mails: (H.E.); (A.E.); (N.B.); (U.M.L.)
| | - Nora Barroso
- Systems Engineering and Automation Department, University of the Basque Country UPV/EHU, Donostia 20018, Spain; E-Mails: (H.E.); (A.E.); (N.B.); (U.M.L.)
| | - Miriam Ecay-Torres
- CITA-Alzheimer Foundation, San Sebastian 20009, Spain; E-Mails: (M.E.-T.); (P.M.-L.)
| | - Pablo Martinez-Lage
- CITA-Alzheimer Foundation, San Sebastian 20009, Spain; E-Mails: (M.E.-T.); (P.M.-L.)
| | - Unai Martinez de Lizardui
- Systems Engineering and Automation Department, University of the Basque Country UPV/EHU, Donostia 20018, Spain; E-Mails: (H.E.); (A.E.); (N.B.); (U.M.L.)
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Hailstone JC, Ridgway GR, Bartlett JW, Goll JC, Crutch SJ, Warren JD. Accent processing in dementia. Neuropsychologia 2012; 50:2233-44. [PMID: 22664324 PMCID: PMC3484399 DOI: 10.1016/j.neuropsychologia.2012.05.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 05/10/2012] [Accepted: 05/24/2012] [Indexed: 11/27/2022]
Abstract
Accented speech conveys important nonverbal information about the speaker as well as presenting the brain with the problem of decoding a non-canonical auditory signal. The processing of non-native accents has seldom been studied in neurodegenerative disease and its brain basis remains poorly understood. Here we investigated the processing of non-native international and regional accents of English in cohorts of patients with Alzheimer's disease (AD; n=20) and progressive nonfluent aphasia (PNFA; n=6) in relation to healthy older control subjects (n=35). A novel battery was designed to assess accent comprehension and recognition and all subjects had a general neuropsychological assessment. Neuroanatomical associations of accent processing performance were assessed using voxel-based morphometry on MR brain images within the larger AD group. Compared with healthy controls, both the AD and PNFA groups showed deficits of non-native accent recognition and the PNFA group showed reduced comprehension of words spoken in international accents compared with a Southern English accent. At individual subject level deficits were observed more consistently in the PNFA group, and the disease groups showed different patterns of accent comprehension impairment (generally more marked for sentences in AD and for single words in PNFA). Within the AD group, grey matter associations of accent comprehension and recognition were identified in the anterior superior temporal lobe. The findings suggest that accent processing deficits may constitute signatures of neurodegenerative disease with potentially broader implications for understanding how these diseases affect vocal communication under challenging listening conditions.
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Affiliation(s)
- Julia C. Hailstone
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Gerard R. Ridgway
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Jonathan W. Bartlett
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Johanna C. Goll
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Jason D. Warren
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
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Wilson R, Rochon E, Mihailidis A, Leonard C. Examining success of communication strategies used by formal caregivers assisting individuals with Alzheimer's disease during an activity of daily living. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2012; 55:328-341. [PMID: 22199204 DOI: 10.1044/1092-4388(2011/10-0206)] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To examine how formal (i.e., employed) caregivers' use verbal and nonverbal communication strategies while assisting individuals with moderate to severe Alzheimer's disease (AD) during the successful completion of an activity of daily living (ADL). Based on the literature, the authors hypothesized that caregivers' use of 1 proposition, closed-ended questions, and repetition would be of most benefit. METHOD Twelve caregiver-AD dyads participated in this observational study. Each dyad was videorecorded on 6 separate occasions while completing handwashing. Handwashing sessions were transcribed and systematically coded for the use of communication strategies during completion of the ADL. RESULTS Caregiver-AD dyads successfully completed 90% of all handwashing sessions, and caregivers employed a variety of communication strategies. Consistent with our hypotheses, during successful task completion, caregivers most frequently provided individuals with AD with 1 direction or idea (i.e., proposition) at a time, closed-ended questions, and paraphrased repetition. Caregivers also frequently used encouraging comments and the resident's name during the task; however, use of these strategies was not correlated to task success rate. CONCLUSION This study adds to the limited body of evidence supporting the use of specific communication strategies by caregivers assisting individuals with moderate to severe AD during successful completion of ADLs.
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