Agentic Cognitive Profiling: Realigning Automated Alzheimer's Disease Detection with Clinical Construct Validity

Automated Alzheimer's Disease (AD) screening has predominantly followed the inductive paradigm of pattern recognition, which directly maps the input signal to the outcome label. This paradigm sacrifices construct validity of clinical protocol for statistical shortcuts. This paper proposes Agentic Cognitive Profiling (ACP), an agentic framework that realigns automated screening with clinical protocol logic across multiple cognitive domains. Rather than learning opaque mappings from transcripts to labels, the framework decomposes standardized assessments into atomic cognitive tasks and orchestrates specialized LLM agents to extract verifiable scoring primitives. Central to our design is decoupling semantic understanding from measurement by delegating all quantification to deterministic function calling, thereby mitigating hallucination and restoring construct validity. Unlike popular datasets that typically comprise around a hundred participants under a single task, we evaluate on a clinically-annotated corpus of 402 participants across eight structured cognitive tasks spanning multiple cognitive domains. The framework achieves 90.5% score match rate in task examination and 85.3% accuracy in AD prediction, surpassing popular baselines while generating interpretable cognitive profiles grounded in behavioral evidence. This work demonstrates that construct validity and predictive performance need not be traded off, charting a path toward AD screening systems that explain rather than merely predict.

Improving Grapheme-to-Phoneme Conversion through In-Context Knowledge Retrieval with Large Language Models

Grapheme-to-phoneme (G2P) conversion is a crucial step in Text-to-Speech (TTS) systems, responsible for mapping grapheme to corresponding phonetic representations. However, it faces ambiguities problems where the same grapheme can represent multiple phonemes depending on contexts, posing a challenge for G2P conversion. Inspired by the remarkable success of Large Language Models (LLMs) in handling context-aware scenarios, contextual G2P conversion systems with LLMs' in-context knowledge retrieval (ICKR) capabilities are proposed to promote disambiguation capability. The efficacy of incorporating ICKR into G2P conversion systems is demonstrated thoroughly on the Librig2p dataset. In particular, the best contextual G2P conversion system using ICKR outperforms the baseline with weighted average phoneme error rate (PER) reductions of 2.0% absolute (28.9% relative). Using GPT-4 in the ICKR system can increase of 3.5% absolute (3.8% relative) on the Librig2p dataset.

Towards Within-Class Variation in Alzheimer's Disease Detection from Spontaneous Speech

Alzheimer's Disease (AD) detection has emerged as a promising research area that employs machine learning classification models to distinguish between individuals with AD and those without. Unlike conventional classification tasks, we identify within-class variation as a critical challenge in AD detection: individuals with AD exhibit a spectrum of cognitive impairments. Given that many AD detection tasks lack fine-grained labels, simplistic binary classification may overlook two crucial aspects: within-class differences and instance-level imbalance. The former compels the model to map AD samples with varying degrees of impairment to a single diagnostic label, disregarding certain changes in cognitive function. While the latter biases the model towards overrepresented severity levels. This work presents early efforts to address these challenges. We propose two novel methods: Soft Target Distillation (SoTD) and Instance-level Re-balancing (InRe), targeting two problems respectively. Experiments on the ADReSS and ADReSSo datasets demonstrate that the proposed methods significantly improve detection accuracy. Further analysis reveals that SoTD effectively harnesses the strengths of multiple component models, while InRe substantially alleviates model over-fitting. These findings provide insights for developing more robust and reliable AD detection models.