Predicting Transitions from Mild Cognitive Impairment to Dementia within 5‐years

Abstract

AbstractBackgroundEarly detection of individuals at high risk of future progression toward dementia is in great need, particularly in the era of emerging treatments for Alzheimer’s disease. Given the easier administration of neuropsychological (NP) tests over invasive and expensive biomarker acquisition, we seek to predict the future cognitive status of an individual based on digital voice recordings of NP exams.MethodWe utilized automatic speech recognition and natural language processing techniques to create an automated tool that predicts if an individual with mild cognitive impairment (MCI) will develop dementia in a fixed follow‐up window (5 years). We characterize the predictive accuracy of this approach using data from the Framingham Heart Study. First, the automated transcription of the digital voice recordings were classified into 8 main NP sub‐tests including memory assessment, naming and language skill, verbal fluency, general questions, etc. Using a large language model, only the participants’ sentences were encoded into quantitative data. These data and the participants’ characteristics, such as age, sex, ApoE4 (+/‐) genotype, and education were employed to train and test a binary classifier, predicting dementia withing 5 years after a positive MCI diagnosis. We also provide a comparison between our approach and alternative models using demographics and ApoE genotype or the Mini‐Mental State Examination (MMSE) score.ResultWe evaluated the performance of the classification task on the data containing 111 stable MCI and 103 progressive MCI subjects. Our method achieved an average accuracy of 75.5% on the held‐out test data while a baseline model using age, sex, education, and ApoE has an average accuracy of 71.8%. The sensitivity and specificity of the proposed method versus the baseline model are 78.2% vs. 81.8% and 72.7% vs. 61.8%, respectively. Our approach also significantly outperforms the model based on the MMSE score by a margin of 14% in accuracy.ConclusionWe have analyzed digital voice recordings of NP exams for participants with MCI to predict their cognitive status in 5 years. The proposed approach offers a fully automated procedure with higher accuracy, providing an opportunity to develop an accessible and easy‐to‐administer screening tool that could be easily adapted to any language.