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.

Towards Multi-Level Transcript Segmentation: LoRA Fine-Tuning for Table-of-Contents Generation

Segmenting speech transcripts into thematic sections benefits both downstream processing and users who depend on written text for accessibility. We introduce a novel approach to hierarchical topic segmentation in transcripts, generating multi-level tables of contents that capture both topic and subtopic boundaries. We compare zero-shot prompting and LoRA fine-tuning on large language models, while also exploring the integration of high-level speech pause features. Evaluations on English meeting recordings and multilingual lecture transcripts (Portuguese, German) show significant improvements over established topic segmentation baselines. Additionally, we adapt a common evaluation measure for multi-level segmentation, taking into account all hierarchical levels within one metric.