Newswise — A new study led by Columbia Nursing Assistant Professor Maryam Zolnoori, PhD, and published in the July 17, 2023, online issue of Artificial Intelligence in Medicine, analyzes the performance of ADscreen, a computerized speech processing algorithm she is developing to support clinicians in detecting and monitoring the progression of Alzheimer's disease and related dementias (ADRDs). To conduct this study, the Columbia Nursing research team has received two awards, totaling $1.2 million, from the National Institute on Aging.

Using a dataset featuring voice recordings from ADRDs patients, Zolnoori and her colleagues programmed ADscreen to look for changes in the acoustic and linguistic parts of speech. For acoustic parts of speech, the research team modeled speech fluency, frequency, and spectral parameters, as well as voice’s intensity, rhythmic structure, and quality. For linguistic parts of speech, they modeled semantic disfluency, lexical richness, syntactic structure, and psycholinguistic structure in patients’ voices. These speech parameters are the earliest signs of cognitive impairment caused by ADRDs. ADscreen flags such alterations and provides extensive data visualizations on the extent of each change.

In the United States, around five million people (about twice the population of Mississippi)—including 11% of older adults—are affected by ADRDs. Half of those with ADRDs remain undiagnosed and undertreated, burdening patients, caregivers, and the health care system.  

“This technology is cost-effective, non-invasive, and remarkably sensitive. We found it can be integrated into clinical workflows, enabling the early detection of cognitive impairment in patients. This identification facilitates the delivery of appropriate and timely care. It's also worth noting that no commercially available algorithm utilizes audio-recorded verbal communication for cognitive impairment detection.” says Zolnoori.  

Joining her in conducting the study were Associate Professor Maxim Topaz, PhD, of Columbia Nursing, and Ali Zolnour, of the University of Tehran’s School of Electrical and Computer Engineering.

“The next phase will be to test and finetune this tool in a clinical setting with patients,” explains Topaz.

For this phase, the Columbia Nursing research team will be collaborating with VNS Health, one of the nation’s largest home- and community-based health care nonprofits and where both Topaz and Zolnoori conduct clinical research.

VNS Health will play a key role by facilitating testing of the screening algorithm at the organization. The nonprofit is now in the initial stages of enlisting home care nurses across the organization to further develop the technology with consenting patients in the field.

Research around this topic first began in 2020 when Zolnoori observed her 55-year-old aunt’s battle with Alzheimer's disease.

“Over a 10-year span, my aunt’s condition deteriorated despite checkups. When she was finally diagnosed, it was too late for any treatment. Early detection could have made a difference by slowing down or reversing the progression of the disease with appropriate interventions.”

To learn more about this work, click here.

Journal Link: Artificial Intelligence in Medicine