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This research introduces CCMAN, a transformer-based framework that leverages cross-modal attention to extract interpretable temporal biomarkers from speech for early cognitive decline detection. By analyzing semantic drift and pause variance across diverse memory tasks, the model outperforms static baselines in distinguishing healthy controls from those with mild cognitive impairment or dementia. The approach advances AI applications in healthcare by providing a scalable, non-invasive method that captures dynamic speech instability rather than relying on aggregated features.
CCMAN: Cognitive Instability-Aware Cross-Modal Attention Network for Interpretable Temporal Biomarkers of Verbal Fluency Speech
arXiv:2609.14764v1 Announce Type: cross Abstract: Early detection of cognitive decline from speech offers a scalable and non-invasive alternative to conventional clinical assessment. Verbal fluency tasks are particularly informative, but most automated approaches aggregate features across an entire recording, overlooking temporal speech dynamics. We propose the Cognitive Instability-Aware Cross-Modal Attention Network (CCMAN), a transfer learning framework that learns task-agnostic cognitive speech representations from multiple memory-probing tasks before fine-tuning on a minute-long semantic and phonemic verbal fluency task. CCMAN integrates semantic, acoustic, and linguistic information through bidirectional cross-attention, gated multimodal fusion, and transformer-based temporal modelling to derive interpretable biomarkers of cognitive decline. Experiments were conducted on 165.44 hours of speech from 843 participants (498 healthy controls, 245 with mild cognitive impairment, and 100 with dementia). CCMAN achieved Macro-F1 scores of 0.81 and 0.59 for binary and multiclass semantic fluency classification, and 0.77 and 0.53 for phonemic fluency, consistently outperforming strong static and temporal baselines. Statistical analyses showed that semantic drift variance and pause variance, but not mean semantic drift, were significantly elevated in both MCI and dementia relative to healthy controls, while pause duration increased progressively over the task with the steepest slope in dementia, supporting global and progressive temporal speech instability as interpretable biomarkers. Evaluation on the independent PROCESS-2 benchmark further demonstrated the generalisability of the proposed framework, improving the baseline Macro-F1 by up to 9%. These findings support temporal speech instability as a dynamic speech biomarker for robust, interpretable, and generalisable early detection of cognitive decline.
Abstract:Early detection of cognitive decline from speech offers a scalable and non-invasive alternative to conventional clinical assessment. Verbal fluency tasks are particularly informative, but most automated approaches aggregate features across an entire recording, overlooking temporal speech dynamics. We propose the Cognitive Instability-Aware Cross-Modal Attention Network (CCMAN), a transfer learning framework that learns task-agnostic cognitive speech representations from multiple memory-probing tasks before fine-tuning on a minute-long semantic and phonemic verbal fluency task. CCMAN integrates semantic, acoustic, and linguistic information through bidirectional cross-attention, gated multimodal fusion, and transformer-based temporal modelling to derive interpretable biomarkers of cognitive decline. Experiments were conducted on 165.44 hours of speech from 843 participants (498 healthy controls, 245 with mild cognitive impairment, and 100 with dementia). CCMAN achieved Macro-F1 scores of 0.81 and 0.59 for binary and multiclass semantic fluency classification, and 0.77 and 0.53 for phonemic fluency, consistently outperforming strong static and temporal baselines. Statistical analyses showed that semantic drift variance and pause variance, but not mean semantic drift, were significantly elevated in both MCI and dementia relative to healthy controls, while pause duration increased progressively over the task with the steepest slope in dementia, supporting global and progressive temporal speech instability as interpretable biomarkers. Evaluation on the independent PROCESS-2 benchmark further demonstrated the generalisability of the proposed framework, improving the baseline Macro-F1 by up to 9%. These findings support temporal speech instability as a dynamic speech biomarker for robust, interpretable, and generalisable early detection of cognitive decline.
Sound (cs.SD); Machine Learning (cs.LG); Audio and Speech Processing (eess.AS)
arXiv:2609.14764 [cs.SD]
(or arXiv:2609.14764v1 [cs.SD] for this version)
https://doi.org/10.48550/arXiv.2609.14764 Focus to learn more arXiv-issued DOI via DataCite (pending registration)
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