Predictors of Loneliness in Older Adults Using Multimodal Analysis of Speech and Language

Loneliness is a critical public health issue among older adults, linked to higher risks of depression, cognitive decline, and mortality. Scalable, objective methods for its detection remain limited, particularly in natural conversational contexts. We analyzed speech and language markers of loneliness in 310 older adults using semi-structured telephone interviews to help understand how they process feeling lonely and how their language differs at different levels of feeling loneliness. Our multimodal framework combined linguistic features (psycholinguistic dictionaries, n-grams, and topic models) with acoustic features (pitch, tone, loudness) to examine associations with self-reported loneliness scores. Both predefined and data-driven methods captured patterns in verbal content and vocal delivery. Higher loneliness was associated with negations(r = 0.11), negative tone(r = 0.12), and conflict-related language. Lower loneliness was linked to social references(r = -0.18), motivational drives(r = -0.11), and emotional richness in speech(r = -0.12). We also found that the multimodal model (r = 0.298) outperforms the text-only and audio-only models. Findings suggest that loneliness manifests through both linguistic and acoustic cues, supporting the potential of speech-based analysis in psychological assessments and as an early indicator of emotional loneliness when used alongside existing assessments, rather than as standalone diagnostic tools.

VocalAffectBench: Evaluating Vocal Emotion Recognition in AI Audio Models

Voice products increasingly need affective cues that are present in speech but absent from transcripts. We introduce VocalAffectBench, a public, test-only benchmark for evaluating whether AI audio models can identify expressed vocal emotion from raw audio. The benchmark contains 273 human-recorded English WAV clips from 51 speaker accounts totaling 1.95 hours across seven labels: angry, disgusted, fearful, happy, neutral, sad, and surprised, with 39 clips per class. All baselines are evaluated from audio alone, without transcripts or contextual metadata. Across six released baselines, average accuracy is 35.5%. The strongest baseline, gemini_3_5_flash, reaches 46.5% on the seven-way task, above the 14.3% random baseline but far from robust emotion recognition. A secondary valence-bucket analysis maps labels into positive, neutral, and negative classes, excluding surprised because its valence is ambiguous. Aggregate accuracy under this coarser view is 50.9%. Performance is highly uneven across classes. By recall, neutral is identified most reliably at 75.6% averaged across baselines, while surprised and fearful reach only 10.7% and 15.4%, respectively. These results show that the evaluated baselines can extract some affective signal from speech, but discrete expressed-emotion recognition remains fragile, especially for non-neutral emotions that are often most important in voice agent workflows.

Letters hide the truth from our eyes: English homophones have meaningfully different phonetic realizations

The distribution of spoken word duration of English homophones is known to co-vary with frequency of use. This study investigates whether other aspects of the phonetic realization of homophones also differ. A series of quantitative investigations of 14,000 homophone tokens in American television news broadcasts revealed that the tokens of homophone pairs such as \textit{weight} and \textit{wait} have different phonetic realizations, and that these can be predicted from their meanings in utterance context. These systematic differences remain even when taking duration-related variation into account. Time-normalized spectrograms emerged as an excellent tool for probing the fine details of phonetic realization, and obviate the need for phonetic transcriptions, which inevitably hide the phonetic truth from our eyes.

AudioLens: Multi-Perspective Speech Clustering with Reasoning Audio-Language Models

Audio clustering is a fundamental task for organizing rapidly growing speech collections, supporting applications such as conversational analysis and speech-driven discovery. However, existing methods rely on fixed acoustic similarity metrics or ASR-based text pipelines, limiting their ability to reorganize the same audio collection under different user-specified perspectives, especially when clustering depends on both linguistic and paralinguistic cues. We introduce audio multi-perspective clustering, where a model directly partitions speech recordings according to a natural-language perspective while inferring both the number of clusters and their assignments. To study this setting, we construct AudioLens-Bench, a benchmark spanning multiple application domains and evaluating both in-perspective and cross-perspective generalization. We further propose AudioLens-R1, an end-to-end large audio-language model trained with reasoning distillation and preference optimization. Experiments show that AudioLens-R1 consistently outperforms all baselines, improving overall ARI by 12.99 points and V-measure by 11.62 points. These results demonstrate the promise of native audio-language models for flexible, perspective-conditioned structure discovery over speech collections.

Motor, Cognitive, or Corpus? What Survives Cross-Lingual Transfer in Speech-Based Parkinsons Disease Detection

Self-supervised learning (SSL) speech representations achieve strong performance for Parkinson's disease (PD) detection within individual corpora. However, it remains unclear whether these models capture disease-related characteristics or exploit dataset-specific confounds, particularly since most SSL backbones are pretrained exclusively on healthy speech. To investigate this question, we perform a layer-wise analysis of nine SSL speech backbones using a low-capacity logistic regression probe across three languages. We structure the evaluation as multiple scenarios that progressively introduce distribution shifts in participant identity, recording conditions, language, and pathology. Our results reveal two key findings. First, layer selection is highly corpus-dependent: the optimal representation layer is determined primarily by the source dataset rather than by the SSL architecture itself. Second, the transferred discriminative signal lacks pathological specificity: classifiers trained to detect PD assign similarly high probabilities to both PD and dementia speech in the target corpus. These results highlight critical limitations that must be addressed before speech-based pathology recognition models can be reliably deployed in clinical settings.

LSEAD: A Privacy-Preserving LLM-Based Speech Analysis Framework for Early Alzheimer's Disease Screening

Early diagnosis of Alzheimer's disease (AD) is critical for enabling timely interventions that may slow disease progression and improve patient outcomes. There is a growing need for AD detection methods that are non-invasive and cost-effective, especially in real-world clinical settings with diverse patient populations and recording conditions. Speech-based screening addresses these needs by using natural speech collected without specialized equipment. Recent advances in large language models (LLMs) have improved speech analysis by providing rich linguistic representations and strong generalization. In this study, we propose LSEAD, a speech-based AD detection framework using pretrained open-source LLMs. Speech recordings are automatically transcribed, and text embeddings are extracted using locally deployed LLMs. Principal component analysis (PCA) is applied to reduce dimensionality before classification. Because the framework relies only on speech transcripts and locally deployed models, it supports privacy-preserving AD risk assessment without external data exchange. We evaluate LSEAD on the ADReSS20 and ADReSSo2021 benchmark datasets. Experimental results show that LLM-based embeddings generalize well across datasets and improve AD classification accuracy by up to 5 percent over existing methods, especially for early-stage detection. These results demonstrate that LSEAD provides a practical, secure, and scalable approach for early AD screening.

Toward Generalizable Cognitive Impairment Detection with Speech-Based Multimodal Large Language Models

Cognitive impairment (CI) is a growing public health concern. Early and accurate diagnosis is critical for enabling timely intervention and improving patient outcomes. Speech-based CI detection has emerged as a promising non-invasive approach, as speech signals encode both linguistic and acoustic markers associated with cognitive decline. Recent advances in large language models (LLMs) further strengthen the potential of speech-based assessment by enabling more expressive representation learning and improved generalization across diverse speakers, recording devices, and clinical environments. Moreover, multimodal learning by jointly modeling linguistic and acoustic features allows for a more comprehensive characterization of cognitive and behavioral changes related to CI, leading to more reliable detection. In this work, we propose a multimodal CI detection framework based on open-source LLMs that integrates speech audio and corresponding transcripts while preserving patient privacy. Acoustic embeddings are extracted directly from speech signals, while textual embeddings are generated from automatically transcribed speech. These modality-specific embeddings are then concatenated to create a combined feature vector and used for downstream classification, without requiring access to raw or sensitive patient data. The proposed approach is evaluated on the ADReSS20 and ADReSSo21 benchmark datasets. Experimental results show that the proposed multimodal framework achieves an CI classification accuracy of 92.4% and consistently outperforms single-modality baselines. Our work establishes a new state-of-the-art for CI identification, with the proposed method demonstrating superior cross-dataset generalization. This advance highlights the power of an LLM-based multimodal framework that fuses linguistic and acoustic data to enable robust, scalable, and non-invasive screening.

Transcript-Free Lightweight Detection of Alzheimer's Disease from Spontaneous Speech Using Handcrafted MFCC-Dominant Acoustic Biomarkers

It is still hard to find Alzheimer's disease (AD) early, especially when neuroimaging is expensive or tools that depend on language are not available. Spontaneous speech provides a non-invasive signal; however, numerous current methodologies depend on transcripts/ASR or computationally intensive deep models. We offer a simple, audio-only baseline for detecting AD using 176 Cookie Theft recordings from the DementiaBank Pitt corpus (88 AD, 88 controls). WebRTC voice activity detection (VAD) is used to separate speech from non-speech. We take out 99 hand-crafted acoustic-temporal features, including pause and fluency statistics, spectral/prosodic descriptors, and MFCC summaries with Δ and ΔΔ. Evaluation is performed using a stringent speaker-independent GroupShuffleSplit,documenting performance across 30 iterations. A lightweight SVM with an RBF kernel gets an average AUC of 0.674 across runs. For example, a single split has an AUC of 0.742 and an accuracy of 0.657. We also present an exploratory compact-feature analysis utilizing a Top-20 subset ranked by Random Forest importance; since selection is not nested within training splits, these results may be overly optimistic and are not employed for primary conclusions (AUC 0.719). The results indicate that transcript-free spectro-temporal and fluency-related cues can facilitate speaker-independent Alzheimer's disease screening from raw audio, establishing a practical foundation for deployment-oriented research.

Speech Playground: An Interactive Tool for Speech Analysis and Comparison

This paper presents Speech Playground, an interactive speech visualization and comparison tool. While existing tools such as Praat are excellent, it can be cumbersome to integrate them with modern deep learning representations and use them for comparison. Speech Playground addresses this by combining a Python backend with a web-based frontend for interactive exploration of multiple feature types, including continuous, discrete, and variable-length representations. It includes TextGrid and forced alignment support together with configurable distance and alignment settings for visual and auditory comparison. Speech Playground is intended for use in speech research, representation validation, and computer-aided pronunciation training (CAPT)-oriented experimentation.

Gated Multi-Graph Fusion via Graph Attention Networks for Alzheimer's Disease Detection

Spontaneous speech is a vital non-invasive biomarker for Alzheimer's Disease (AD), yet many systems overlook non-linear structural disruptions and clinical heterogeneity in pathological language. We propose a Multi-View Gated Graph Attention Network that transcribes audio via Automatic Speech Recognition (ASR) to construct semantic, dependency, and co-occurrence graphs, characterizing speech through a "content-structure-flow" framework. Notably, the co-occurrence graph leverages Pointwise Mutual Information (PMI) from a normative corpus to quantify narrative logic and linguistic deviation. To address symptomatic diversity, an adaptive gated fusion mechanism dynamically integrates these views. Evaluated on the ADReSSo dataset, our model achieves 90.00% accuracy. Ablation results confirm that the PMI-based graph and heterogeneity-aware gating are essential for robust classification across diverse clinical populations. Our source code is publicly available at https://github.com/opeacc/AD.

From Black-Box to Clinical Insight: A Multi-Stage Explainable Framework for Speech-Based Cognitive Impairment Detection

Speech-based cognitive impairment detection offers a noninvasive, accessible alternative to costly biomarker assays, yet transformer-based models remain clinically uninterpretable. We propose a multi-stage explainability framework that translates black-box transformer predictions into clinically grounded narratives by integrating SHapley Additive exPlanations (SHAP)-based token attribution, theory-informed linguistic features, and a four-stage LLM reasoning pipeline using LLaMA-3.1-70B-Instruct. Built on the SpeechCARE-Adaptive Gating Network multimodal screening model (F1 = 72.11% on the NIA PREPARE benchmark), the framework maps model outputs to four cognitive-linguistic dimensions, including lexical richness, syntactic complexity, and semantic coherence. Physician evaluation on 70 stratified English samples demonstrated strong alignment with patient-level cognitive profiles, and a System Usability Scale score of 82/100 indicated high potential for clinical workflow integration.

LoRA-Tuned Large Language Models for Dementia Detection via Multi-View Speech-Derived Features

Early detection of dementia enables timely intervention, and reflecting cognitive impairment, spontaneous speech offers a non-invasive screening modality. Conventional approaches often focus on a single representational dimension -- such as acoustic descriptors, pause modeling, automatic speech recognition (ASR) transcripts, or multimodal fusion -- limiting integrative reasoning across heterogeneous cognitive symptoms. We propose a low-rank adaptation (LoRA)-tuned large language model (LLM) that performs structured multi-view reasoning over four complementary speech-derived signals: ASR transcripts with pause markers, discourse-level topic cues, temporal fluency statistics, and phonological sequences. These cues are encoded within a unified prompt, enabling a single LLM to learn a coherent decision function without modality-specific encoders or late-stage fusion. On ADReSSo, our best model achieves an F1-score of 90.14%, and ablation confirms the complementary contribution of each view.

Listening Between the Lines: Joint Learning of ASR Embeddings and LLM-Augmented Linguistics for Dementia Detection

Early detection of dementia through speech analysis offers a non-invasive screening alternative, but capturing both acoustic and linguistic biomarkers remains challenging. We propose a multimodal framework leveraging Whisper for dual-purpose extraction: acoustic representations from encoder outputs and transcripts via automatic speech recognition (ASR). For the acoustic pathway, temporal networks with attention pooling aggregate variable-length sequences into fixed-dimensional embeddings. For the linguistic pathway, we prompt a large language model (LLM) to extract interpretable features spanning lexical diversity, syntactic complexity, semantic coherence, and discourse patterns. A gated fusion network integrates both modalities. On ADReSS and ADReSSo, our method achieves F1-scores of 89.47% and 90.14%, demonstrating effective integration of acoustic and LLM-augmented linguistic features. Ablation shows that multimodal fusion consistently outperforms either modality alone.

PHAST-Net: Attention-Guided, Physics-Informed Network for Unified Estimation of Ideal Time-Frequency Representations

We introduce PHAST-Net, an attention-guided, physics-informed network for unified estimation of Ideal Time-Frequency Representations (ITFRs), spanning spectral, tempo-based, metrical, and harmonic representations such as Spectrograms, Tempograms, and Metrograms. PHAST-Net learns an application-general mapping from a constellation of wavelet transforms, the proposed Continuous Log-frequency Adaptive Wavelet Transform (CLAWT), to high-resolution, cross-term-suppressed time-frequency (T-F) representations. The proposed constellation of CLAWTs is selected through Cohen's class kernel analysis to maximise curvature coverage in a logarithmic-frequency T-F plane tailored to harmonic signal structure. PHAST-Net further incorporates a proposed physics-informed auxiliary reprojection loss designed to reconstruct the idealised observed CLAWT constellation from the predicted ITFR and the corresponding Cohen's class kernels during training. This auxiliary objective promotes transform consistency and energy conservation, mitigates pathological target sparsity, and enhances optimisation stability. Attention layers further promote effective cross-term suppression across the input constellation. The log-frequency formulation also enables Harmonic PHAST-Net, which estimates a Harmonic ITFR that isolates fundamental structure, supporting robust fundamental-only representations for speech and music, such as derived fundamental Tempograms and Metrograms. We further introduce Spline-PHAST-Net, which parameterises detected and associated T-F ridges as continuous spline trajectories, enabling arbitrary-grid re-rendering and signal reconstruction. Trained on an effectively unbounded procedurally generated dataset, PHAST-Net demonstrates improved accuracy over established approaches, providing a unified framework for high-resolution, cross-term-robust analysis of speech, music, and broader nonstationary signals.

Segment-Level Mandarin Chinese Speech-Based Cognitive Impairment Detection via an Autoencoder with Contrastive Learning

\noindent\textbf{Background and Objective:} Speech has emerged as a low-cost and non-invasive digital biomarker with considerable potential for cognitive impairment detection. However, limited labeled data and cross-dataset variability remain major challenges for robust speech-based screening systems. \par\noindent\textbf{Methods:} We developed a segment-level representation learning framework for speech-based cognitive impairment detection. Speech recordings were divided into short segments and converted into spectrogram representations. To improve robustness under limited-data conditions, offline and online augmentation strategies were combined with autoencoder-based representation learning and contrastive objectives to enhance discriminative latent representations. \par\noindent\textbf{Results:} Experiments conducted on four independent Mandarin Chinese speech datasets demonstrated stable and competitive performance in both binary and three-class classification tasks, with particularly notable improvements in the clinically challenging three-class setting. Ablation studies further supported the effectiveness of the proposed framework. \par\noindent\textbf{Conclusions:} The findings suggest that segment-level speech representation learning may provide a scalable and practical approach for cognitive impairment screening in resource-constrained clinical settings.

Mitigating Scoring Errors and Compensating for Nonverbal Subtests in Speech-Based Dementia Assessment

Early detection of cognitive impairment relies on neuropsychological tests to minimize subjectivity by assessing multiple cognitive domains. Speech-based evaluation can support diagnostics and improve accessibility, but transcription errors and the omission of nonverbal subtests (e.g., motor skills) limit accuracy. Beyond conventional test scores, speech-derived features can provide additional insights into cognitive status. This study investigates the speech-based evaluation of the German "Syndrom-Kurz-Test," a standardized dementia screening test comprising verbal and motor subtests. We train models that integrate transcript-derived scores and Whisper embeddings per verbal subtest to reduce scoring errors. To compensate for missing motor subtests, we then leverage these fused representations to approximate expert overall ratings. Despite omitting subtests, our models strongly correlate with expert ratings and efficiently and accurately discriminate between cognitive status groups.

Fair Cognitive Impairment Detection Through Unlearning

Mild Cognitive Impairment (MCI) is a medical condition characterized by a noticeable decline in memory, language, or thinking abilities. MCI detection from spontaneous speech is promising for scalable screening. However, learned models often exploit demographic cues correlated with labels, resulting in a large performance gap across subgroups. We present a multimodal framework that combines (i) cross-model fusion between modalities (speech, text, and image), and (ii) unlearning using gradient reversal that discourages the shared embedding from encoding task-irrelevant demographic attributes. Evaluated on the multilingual benchmarks TAUKADIAL and PREPARE, our method outperforms the state-of-the-art multilingual and multimodal baseline in MCI classification while substantially reducing the performance gap across patient subgroups (sex and language). We further analyze transfer across datasets, showing that demographic unlearning helps learn more robust representations for MCI detection.

Reading between the Lines: Leveraging Large Language Models for Global Dementia and Depression Assessment from Clinical Interviews

Dementia and depression are the most prevalent neuropsychiatric disorders in geriatric populations, and their overlapping symptoms pose major challenges for differential diagnosis. In this study, we investigate open-weights Large Language Models (LLMs) for predicting dementia and depression severity from speech samples collected during standardized history taking interviews with 154 German-speaking subjects. We introduce an observer-based Global Depression Scale (GDS-D) aligned with the established Global Deterioration Scale (GDS), enabling parallel global staging of affective and cognitive symptoms. We compare three LLMs (Mistral 3.1, DeepHermes, Qwen3) in two settings: (1) zero-shot prediction and (2) LLM-based feature extraction for Support Vector Regression, using human and pause-enriched transcripts. Results show that LLMs effectively predict depression severity in zero-shot settings (best MAE of 0.60), while dementia assessment benefits substantially from structured feature extraction (best MAE of 0.78), reducing errors by up to 35% over zero-shot baselines. Pause-enriched transcripts achieve competitive performance with human transcriptions, demonstrating the viability of fully automatic screening pipelines for differential neuropsychiatric assessment.

Predicting Cognitive Load from Speech and Interaction Dynamics in Dyadic Conversations

Estimating cognitive load from speech has largely been studied in controlled laboratory settings, with limited understanding of its reliability in natural collaborative conversations. We investigate whether speech and interaction dynamics predict perceived cognitive load during dyadic conversations. We analyze audio from 53 dyads performing nine collaborative tasks and extract static acoustic, dynamic, and interaction features to train a two-head Gated Recurrent Unit encoder to predict cognitive load scores. Results show conversational interaction provides useful signals for predicting cognitive load related to time pressure, mental work, effort, and task performance. Temporal demand is associated with turn-taking dynamics such as overlap and speaker switch, while mental demand is linked to imbalanced participation between speakers. These findings highlight the importance of task structure and conversational interaction for modeling cognitive load in natural collaborative settings.

The Dynamics of Human and AI-Generated Language: How Semantics Fluctuates across Different Timescales

Spoken language, whether produced by humans or large language models (LLM), unfolds over time with varying semantic content. However, we still lack simple, interpretable time-series features that capture how generic versus specific content is distributed over time, and that can be used to compare human and AI-generated speech. We introduce a semantic-timescale analysis pipeline that turns word-level transcripts with timestamps into semantic time-series. For each spoken narrative, we compute (i) semantic specificity using WordNet-based word depth and (ii) contextual similarity using SBERT embeddings and quantify their temporal dependence using autocorrelation-window measures (ACW-0 and related metrics). We then compare original speech to multiple shuffled controls that selectively disrupt lexical identity, temporal order, and word duration. Across human-read autobiographical narratives, TTS readings, and LLM-generated texts rendered with TTS, we find that segments with longer ACW-0 in the semantic time-series tend to contain more generic vocabulary, whereas segments with shorter ACW-0 are enriched in more specific words. These associations are strongly attenuated or abolished when word order and timing are randomized, indicating that ACW-based measures capture non-trivial temporal organization of semantic content beyond static lexical distributions. Our results suggest that ACW-based semantic timescales are a useful family of features for analyzing and comparing the temporal structure of human and AI-generated speech.

Multi-View Speech Representation Learning for Parkinson's Disease Detection Using Context-guided Cross-modal Attention

Parkinson's disease (PD) is a progressive neurodegenerative disorder that frequently causes speech impairments associated with hypokinetic dysarthria. As speech production relies on the precise coordination of complex neuromuscular mechanisms, speech analysis has emerged as a promising non-invasive and cost-effective biomarker for early PD detection. Recent deep learning approaches have shown encouraging results; however, most existing methods rely on a single speech representation, potentially overlooking complementary pathological information encoded across different feature spaces. In this work, we propose a multi-branch deep learning framework for automatic PD detection from speech. Each recording is segmented into 5-second chunks and represented using three complementary modalities: Log-Mel spectrograms, MFCCs, and HuBERT embeddings extracted from raw waveforms. The spectrograms are processed using a pre-trained ResNet-18 encoder, MFCC sequences are modeled through a BiLSTM network, and raw speech is encoded using a pre-trained HuBERT model. To effectively integrate these heterogeneous representations, we introduce a context-guided cross-modal attention mechanism that dynamically weights temporal HuBERT embeddings according to the global acoustic context derived from the spectrogram and MFCC branches. Experiments conducted on the publicly available Spanish PC-GITA corpus under strict speaker-independent 5-fold cross-validation demonstrate the effectiveness of the proposed approach. The proposed architecture achieves an accuracy of 91.51%, an F1-score of 91.24%, and an AUC of 95.97%. Furthermore, ablation studies confirm the contribution of both the proposed context-guided cross-modal attention mechanism and the integration of complementary speech representations. These findings highlight the potential of heterogeneous speech modeling for robust and clinically reliable PD detection.

Recurrence-Based Nonlinear Vocal Dynamics as Digital Biomarkers for Depression Detection from Conversational Speech

Digital biomarkers for depression have largely relied on static acoustic descriptors, pooled summary statistics, or conventional machine learning representations. Such approaches may miss nonlinear temporal organization embedded in conversational vocal dynamics. We hypothesized that depression is associated with altered recurrence structure in vocal state trajectories, reflecting changes in how the vocal system revisits acoustic states over time. Using the depression subset of the DAIC-WOZ corpus with 142 labeled participants, we modeled frame-level COVAREP trajectories as nonlinear dynamical systems and derived recurrence-based biomarkers from 74 vocal channels. Logistic regression with feature selection and stratified cross-validation evaluated classification performance. Recurrence-based biomarkers achieved a mean cross-validated AUC of 0.689, exceeding static acoustic baselines, entropy-dynamics features, Hurst exponent features, determinism features, and Lyapunov-like instability proxies. Permutation testing indicated statistical significance with $p=0.004$. Pooled cross-validated predictions yielded AUC 0.665 with a 95\% bootstrap confidence interval of [0.568, 0.758]. These findings suggest that depression may be characterized by altered recurrence structure in conversational vocal dynamics and support nonlinear state-space analysis as a promising direction for digital psychiatric biomarkers.