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. 2024 Feb 23;16(1):e12557.
doi: 10.1002/dad2.12557. eCollection 2024 Jan-Mar.

Clinical classification of memory and cognitive impairment with multimodal digital biomarkers

Russell Banks  1 , Connor Higgins  2 , Barry R Greene  3 , Ali Jannati  4 , Joyce Gomes-Osman  5 , Sean Tobyne  2 , David Bates  2 , Alvaro Pascual-Leone  2   4   6
Affiliations

Clinical classification of memory and cognitive impairment with multimodal digital biomarkers

Russell Banks et al. Alzheimers Dement (Amst). .

Abstract

Introduction: Early detection of Alzheimer's disease and cognitive impairment is critical to improving the healthcare trajectories of aging adults, enabling early intervention and potential prevention of decline.

Methods: To evaluate multi-modal feature sets for assessing memory and cognitive impairment, feature selection and subsequent logistic regressions were used to identify the most salient features in classifying Rey Auditory Verbal Learning Test-determined memory impairment.

Results: Multimodal models incorporating graphomotor, memory, and speech and voice features provided the stronger classification performance (area under the curve = 0.83; sensitivity = 0.81, specificity = 0.80). Multimodal models were superior to all other single modality and demographics models.

Discussion: The current research contributes to the prevailing multimodal profile of those with cognitive impairment, suggesting that it is associated with slower speech with a particular effect on the duration, frequency, and percentage of pauses compared to normal healthy speech.

Keywords: amnestic MCI; automatic speech recognition; digital clock drawing; mild cognitive impairment; non‐amnestic MCI; speech; verbal memory; voice.

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Conflict of interest statement

Alvaro Pascual‐Leone is a co‐founder and Chief Medical Officer of Linus Health and declares ownership of shares or share options in the company. Alvaro Pascual‐Leone serves as a paid member of the scientific advisory boards for Neuroelectrics, Magstim Inc., TetraNeuron, Skin2Neuron, MedRhythms, and Hearts Radiant. David Bates is a co‐founder and Chief Executive Officer of Linus Health, and declares ownership of shares or share options in the company. John Showalter is the Chief Product Officer of Linus Health and declares ownership of shares or share options in the company. All other authors are employees of Linus Health and declare ownership of shares or share options in the company. Author disclosures are available in the supporting information

Figures

FIGURE 1
FIGURE 1
Above depicts the waveform over time and the estimated speech segments (in green) based on dB level analysis (y axis) over time (x axis; in seconds). The red trace follows fluctuations in dB above the speech threshold. A sample of DCTclock drawing (below left) is provided and scored in terms of drawing efficiency, simple and complex motor, information processing, and spatial reasoning (below right). This individual was classified as having cognitive impairment. DCTclock, digital clock test.
FIGURE 2
FIGURE 2
ROC curves for logistic regression models, evaluated binary classification of cognitive impairment as determined by the RAVLT long delay. AUC, area under the curve; DCR, digital clock and recall; DCRP, Digital Clock and Recall Plus Voice and Speech; DCT, digital clock test (DCTclock); RAVLT, Rey Auditory Verbal Learning Test; ROC, receiver operating characteristic.
See this image and copyright information in PMC

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