Importance of Task Selection for Connected Speech Analysis in Patients with Alzheimer’s Disease from an Ethnically Diverse Sample

Bose, Arpita; Dutta, Manaswita; Dash, Niladri Sekhar; Nandi, Ranita; Dutt, Aparna; Ahmed, Samrah

doi:10.3233/jad-220166

Cited by 4 publications

(4 citation statements)

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“…Regularization bias is less pronounced in speakers of morphologically richer languages (e.g., Italian versus English) (Walenski et al., 2009). Similar tendencies are observed in syntax, with pronoun overuse being significant only in speakers of non‐pro‐drop languages (e.g., English versus Bengali) (Bose et al., 2022).…”

Section: Resultsmentioning

confidence: 57%

Speech changes in old age: Methodological considerations for speech‐based discrimination of healthy ageing and Alzheimer's disease

Ivanova

Martínez-Nicolás

Meilán

2023

Intl J Lang & Comm Disor

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BackgroundRecent evidence suggests that speech substantially changes in ageing. As a complex neurophysiological process, it can accurately reflect changes in the motor and cognitive systems underpinning human speech. Since healthy ageing is not always easily discriminable from early stages of dementia based on cognitive and behavioural hallmarks, speech is explored as a preclinical biomarker of pathological itineraries in old age. A greater and more specific impairment of neuromuscular activation, as well as a specific cognitive and linguistic impairment in dementia, unchain discriminating changes in speech. Yet, there is no consensus on such discriminatory speech parameters, neither on how they should be elicited and assessed.AimsTo provide a state‐of‐the‐art on speech parameters that allow for early discrimination between healthy and pathological ageing; the aetiology of these parameters; the effect of the type of experimental stimuli on speech elicitation and the predictive power of different speech parameters; and the most promising methods for speech analysis and their clinical implications.Methods & ProceduresA scoping review methodology is used in accordance with the PRISMA model. Following a systematic search of PubMed, PsycINFO and CINAHL, 24 studies are included and analysed in the review.Main ContributionThe results of this review yield three key questions for the clinical assessment of speech in ageing. First, acoustic and temporal parameters are more sensitive to changes in pathological ageing and, of these two, temporal variables are more affected by cognitive impairment. Second, different types of stimuli can trigger speech parameters with different degree of accuracy for the discrimination of clinical groups. Tasks with higher cognitive load are more precise in eliciting higher levels of accuracy. Finally, automatic speech analysis for the discrimination of healthy and pathological ageing should be improved for both research and clinical practice.Conclusions & ImplicationsSpeech analysis is a promising non‐invasive tool for the preclinical screening of healthy and pathological ageing. The main current challenges of speech analysis in ageing are the automatization of its clinical assessment and the consideration of the speaker's cognitive background during evaluation.WHAT THIS PAPER ADDSWhat is already known on the subject Societal aging goes hand in hand with the rising incidence of ageing‐related neurodegenerations, mainly Alzheimer's disease (AD). This is particularly noteworthy in countries with longer life expectancies. Healthy ageing and early stages of AD share a set of cognitive and behavioural characteristics. Since there is no cure for dementias, developing methods for accurate discrimination of healthy ageing and early AD is currently a priority. Speech has been described as one of the most significantly impaired features in AD. Neuropathological alterations in motor and cognitive systems would underlie specific speech impairment in dementia. Since speech can be evaluated quickly, non‐invasively and inexpensively, its value for the clinical assessment of ageing itineraries may be particularly high.What this paper adds to existing knowledge Theoretical and experimental advances in the assessment of speech as a marker of AD have developed rapidly over the last decade. Yet, they are not always known to clinicians. Furthermore, there is a need to provide an updated state‐of‐the‐art on which speech features are discriminatory to AD, how they can be assessed, what kind of results they can yield, and how such results should be interpreted. This article provides an updated overview of speech profiling, methods of speech measurement and analysis, and the clinical power of speech assessment for early discrimination of AD as the most common cause of dementia.What are the potential or actual clinical implications of this work? This article provides an overview of the predictive potential of different speech parameters in relation to AD cognitive impairment. In addition, it discusses the effect that the cognitive state, the type of elicitation task and the type of assessment method may have on the results of the speech‐based analysis in ageing.

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Section: Resultsmentioning

confidence: 57%

Speech changes in old age: Methodological considerations for speech‐based discrimination of healthy ageing and Alzheimer's disease

Ivanova

Martínez-Nicolás

Meilán

2023

Intl J Lang & Comm Disor

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“…In addition to this, these studies were primarily concentrated on English speakers (72.7%), while only 27.3% of studies involved other languages. A total number of 15 languages were explored, namely, French ( Hesling et al, 2005 ; Girard et al, 2008 ; Burki et al, 2011 ; Kennedy and Blanchet, 2014 ), Korean ( Mitterer et al, 2013 ; Kim et al, 2022 ), Greek ( Kambanaros, 2014 ), Mitterer and McQueen, 2009 ), Dutch ( Ernestus et al, 2017 ), Norwegian ( Kirmess and Lind, 2011 ), Telugu ( Hivaprasad and Sadanandam, 2020 ), Cantonese ( Yiu et al, 2002 ), Persian ( Daneshi et al, 2020 ), Finnish ( Alexandrou et al, 2017 ), Bengali ( Bose et al, 2022 ), Spanish ( Guzman et al, 2021 ; Gonzalez-Alvarez and Sos-Pena, 2022 ; Lofgren and Hinzen, 2022 ), Portuguese ( Brinca et al, 2014 ; Sampaio et al, 2019 ), Swedish ( Alves et al, 2020 ; Strombergsson et al, 2020 ), Mandarin ( Tsai et al, 2012 ), and Italian (e.g., Cerrato et al, 1998 ; Leoni and Cutugno, 1999 ). In addition to English, studies on Italian connected speech were more abundant than that of other languages.…”

Section: Resultsmentioning

confidence: 99%

“…The common connected speech production measures used for speakers with developmental disorders included behavioral tasks (e.g., story retelling, picture description, word imitation, concurrent commenting, and free conversation), psychiatric rating scales ( De Prete et al, 2021 ), standardized tests ( Kirmess and Lind, 2011 ), corpus analysis, Voxelwise Lesion-Symptom Mapping (VLSM; Stark et al, 2019 ), and functional Magnetic Resonance Imaging (fMRI; Narayana et al, 2020 ). The data drawn from these instruments were processed by various statistical techniques ranging from the K-means algorithm, SPSS, and PRAAT speech software to spectral/cepstral analyses ( Bose et al, 2022 ) for a more accurate and comprehensive evaluation of speech rate, dysfluencies, syntactic, lexical, morphological, and semantic malfunctions.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, the most frequently examined developmental disorder relating to CSP was aphasia ( Conroy et al, 2009 ; Wilson et al, 2010 ; Herbert et al, 2012 ; Croot et al, 2014 ; Casilio et al, 2019 ). The other types of disorders were speech impairment ( Camarata, 1993 ; Howard, 2004 , 2013 ; Alves et al, 2020 ), cognitive impairment ( Kim et al, 2022 ), vocal dysfunction ( Brinca et al, 2014 ), Parkinson’s disease ( Lee et al, 2019 ; Alharbi et al, 2021 ), Down Syndrome ( Iacono, 1998 ), adductor spasmodic dysphonia ( Kave and Goral, 2018 ), Alzheimer’s disease ( Evans et al, 2021 ; Bose et al, 2022 ; Lofgren and Hinzen, 2022 ), voice disorders ( Sampaio et al, 2019 ); hearing loss ( Daneshi et al, 2020 ), and behavioral dysphonia ( Guzman et al, 2021 ).…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of studies on connected speech processing: Trends, key findings, and implications

Zare

Kania

et al. 2022

Front. Psychol.

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Connected speech processing (CSP) is of great significance to individuals’ language and cognitive development. It is particularly crucial not only for clinical detection and treatment of developmental disorders, but also for the Foreign/second language teaching instructions. However, given the importance of this field, there is a clear lack of systematic reviews that summarize the key findings of previous studies. To this end, through searching in the scientific databases PsycInfo, Scopus, PubMed, ERIC, Taylor and Francis, and Web of Science, the present study identified 128 core CSP articles with high reference values according to PRISMA guidance and the following results were obtained through quantitative analysis and qualitative comparative synthesis: (1) The number of studies on CSP published per year showed an upward trend; however, most focused on English language, whereas the studies on other languages were comparatively rare; (2) CSP was found to be affected by multiple factors, among which speech speed, semantics, word frequency, and phonological awareness were most frequently investigated; (3) the deficit in CSP capacity was widely recognized as a significant predictor and indicator of developmental disorders; (4) more studies were carried out on connected speech production than on perception; and (5) almost no longitudinal studies have ever been conducted among either native or non-native speakers. Therefore, future research is needed to explore the developmental trajectory of CSP skills of typically developing language learners and speakers with cognitive disorders over different periods of time. It is also necessary to deepen the understanding of the processing mechanism beyond their performance and the role played by phonological awareness and lexical representations in CSP.

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Universal and Language-Specific Connected Speech Characteristics of Bilingual Speakers With Alzheimer's Disease: Insights From Case Studies of Structurally Distinct Languages

Dutta,

Mello,

Cheng

et al. 2024

J Speech Lang Hear Res

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Purpose: Connected speech analysis has been effectively utilized for the diagnosis and disease monitoring of individuals with Alzheimer's disease (AD). Existing research has been conducted mostly in monolingual English speakers with a noticeable lack of evidence from bilinguals and non-English speakers, particularly in non-European languages. Using a case study approach, we characterized connected speech profiles of two Bengali–English bilingual speakers with AD to determine the universal features of language impairments in both languages, identify language-specific differences between the languages, and explore language impairment characteristics of the participants with AD in relation to their bilingual language experience. Method: Participants included two Bengali–English bilingual speakers with AD and a group of age-, gender-, education-, and language-matched neurologically healthy controls. Connected speech samples were collected in first language (L1; Bengali) and second language (L2; English) using a novel storytelling task (i.e., Frog, Where Are You? ). These samples were analyzed using an augmented quantitative production analysis and correct information unit analyses for productivity, fluency, syntactic and morphosyntactic features, and lexical and semantic characteristics. Results: Irrespective of the language, AD impacted speech productivity (speech rate and fluency) and semantic characteristics in both languages. Unique language-specific differences were noted on syntactic measures (reduced sentence length in Bengali), lexical distribution (fewer pronouns and absence of reduplication in Bengali), and inflectional properties (no difficulties with noun or verb inflections in Bengali). Among the two participants with AD, the individual who showed lower proficiency and usage in L2 (English) demonstrated reduced syntactic complexity and morphosyntactic richness in English. Conclusions: Evidence from these case studies suggests that language impairment features in AD are not universal across languages, particularly in comparison to impairments typically associated with language breakdowns in English. This study underscores the importance of establishing connected speech profiles in AD for non–English-speaking populations, especially for structurally different languages. This would in turn lead to the development of language-specific markers that can facilitate early detection of language deterioration and aid in improving diagnosis of AD in individuals belonging to underserved linguistically diverse populations. Supplemental Material: https://doi.org/10.23641/asha.25412458

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Importance of Task Selection for Connected Speech Analysis in Patients with Alzheimer’s Disease from an Ethnically Diverse Sample

Cited by 4 publications

References 32 publications

Speech changes in old age: Methodological considerations for speech‐based discrimination of healthy ageing and Alzheimer's disease

Speech changes in old age: Methodological considerations for speech‐based discrimination of healthy ageing and Alzheimer's disease

A systematic review of studies on connected speech processing: Trends, key findings, and implications

Universal and Language-Specific Connected Speech Characteristics of Bilingual Speakers With Alzheimer's Disease: Insights From Case Studies of Structurally Distinct Languages

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