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Predicting mild cognitive impairment from spontaneous spoken utterances.

ABSTRACT: INTRODUCTION:Trials in Alzheimer's disease are increasingly focusing on prevention in asymptomatic individuals. We hypothesized that indicators of mild cognitive impairment (MCI) may be present in the content of spoken language in older adults and be useful in distinguishing those with MCI from those who are cognitively intact. To test this hypothesis, we performed linguistic analyses of spoken words in participants with MCI and those with intact cognition participating in a clinical trial. METHODS:Data came from a randomized controlled behavioral clinical trial to examine the effect of unstructured conversation on cognitive function among older adults with either normal cognition or MCI (ClinicalTrials.gov: NCT01571427). Unstructured conversations (but with standardized preselected topics across subjects) were recorded between interviewers and interviewees during the intervention sessions of the trial from 14 MCI and 27 cognitively intact participants. From the transcription of interviewees recordings, we grouped spoken words using Linguistic Inquiry and Word Count (LIWC), a structured table of words, which categorizes 2500 words into 68 different word subcategories such as positive and negative words, fillers, and physical states. The number of words in each LIWC word subcategory constructed a vector of 68 dimensions representing the linguistic features of each subject. We used support vector machine and random forest classifiers to distinguish MCI from cognitively intact participants. RESULTS:MCI participants were distinguished from those with intact cognition using linguistic features obtained by LIWC with 84% classification accuracy which is well above chance 60%. DISCUSSION:Linguistic analyses of spoken language may be a powerful tool in distinguishing MCI subjects from those with intact cognition. Further studies to assess whether spoken language derived measures could detect changes in cognitive functions in clinical trials are warrented.

SUBMITTER: Asgari M

PROVIDER: S-EPMC5651423 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Predicting mild cognitive impairment from spontaneous spoken utterances.

Asgari Meysam M Kaye Jeffrey J Dodge Hiroko H

Alzheimer's & dementia (New York, N. Y.) 20170227 2

<h4>Introduction</h4>Trials in Alzheimer's disease are increasingly focusing on prevention in asymptomatic individuals. We hypothesized that indicators of mild cognitive impairment (MCI) may be present in the content of spoken language in older adults and be useful in distinguishing those with MCI from those who are cognitively intact. To test this hypothesis, we performed linguistic analyses of spoken words in participants with MCI and those with intact cognition participating in a clinical tri ...[more]

PMID: 29067328

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Project description:IntroductionMild cognitive impairment (MCI) is associated with an increased risk of developing dementia. However, many individuals diagnosed with MCI are found to have reverted to normal cognition on follow-up. This study investigated factors predicting or associated with reversion from MCI to normal cognition.MethodsOur analyses considered 223 participants (48.9% male) aged 71-89 years, drawn from the prospective, population-based Sydney Memory and Ageing Study. All were diagnosed with MCI at baseline and subsequently classified with either normal cognition or repeat diagnosis of MCI after two years (a further 11 participants who progressed from MCI to dementia were excluded). Associations with reversion were investigated for (1) baseline factors that included diagnostic features, personality, neuroimaging, sociodemographics, lifestyle, and physical and mental health; (2) longitudinal change in potentially modifiable factors.ResultsThere were 66 reverters to normal cognition and 157 non-reverters (stable MCI). Regression analyses identified diagnostic features as most predictive of prognosis, with reversion less likely in participants with multiple-domain MCI (p?=?0.011), a moderately or severely impaired cognitive domain (p?=?0.002 and p?=?0.006), or an informant-based memory complaint (p?=?0.031). Reversion was also less likely for participants with arthritis (p?=?0.037), but more likely for participants with higher complex mental activity (p?=?0.003), greater openness to experience (p?=?0.041), better vision (p?=?0.014), better smelling ability (p?=?0.040), or larger combined volume of the left hippocampus and left amygdala (p<0.040). Reversion was also associated with a larger drop in diastolic blood pressure between baseline and follow-up (p?=?0.026).DiscussionNumerous factors are associated with reversion from MCI to normal cognition. Assessing these factors could facilitate more accurate prognosis of individuals with MCI. Participation in cognitively enriching activities and efforts to lower blood pressure might promote reversion.

Project description:ImportanceAlthough white matter hyperintensities (WMHs) are associated with the risk for Alzheimer disease, it is unknown whether they represent an independent source of impairment or interact with known markers of disease.ObjectiveTo examine the degree to which WMHs predict aggressive cognitive decline among individuals with mild cognitive impairment, either independently or by modifying the effects of entorhinal cortex volume (ECV), a marker of Alzheimer disease-related neurodegeneration.Design, setting, and participantsThe Alzheimer's Disease Neuroimaging Initiative is a longitudinal study with 6-month follow-up visits. Three hundred thirty-two participants (mean [SD] age, 74.6 [7.4] years; 118 women) of a total of 374 participants diagnosed as having mild cognitive impairment were included. Participants were excluded if they did not have longitudinal data, apolipoprotein E genotype data, or had evidence of supratentorial infarct.Main outcomes and measuresA decline in Mini-Mental State Examination score of 3 points over 6 months or 6 points over 1 year between consecutive visits was defined as aggressive decline. White matter hyperintensity volume and ECV were entered as predictors in Cox proportional hazards models and Wilcoxon-Breslow tests to examine their impact on this outcome, adjusting for sex, age, education, and apolipoprotein E status.ResultsGreater WMH volume at baseline, apolipoprotein E ε4 status, and smaller ECV at baseline were associated with an increased risk for aggressive decline (hazard ratio [HR], 1.23; 95% CI, 1.05-1.43; P = .01 for WMH volume; HR, 1.49; 95% CI, 1.09-2.05; P = .04 for apolipoprotein E ε4 status; HR, 0.66; 95% CI, 0.55-0.79; P < .001 for ECV). White matter hyperintensity volume modified the effect of ECV on aggressive decline risk: individuals with high ECV and low WMH were at particularly low likelihood of decline (χ2 = 15, P = .001). Participants with Mini-Mental State Examination scores that declined by 3 or more points over 6 months or 6 or more points over 12 months were more likely to have converted to Alzheimer disease by the end of the follow-up period (χ2 = 82, P < .001).Conclusions and relevanceWhite matter hyperintensity burden and ECV predict rapid cognitive decline among individuals with mild cognitive impairment both additively and multiplicatively.

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Predicting mild cognitive impairment from spontaneous spoken utterances.

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Predicting mild cognitive impairment from spontaneous spoken utterances.

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