A machine learning-based linguistic battery for diagnosing mild cognitive impairment due to Alzheimer's disease

PLoS One. 2020 Mar 5;15(3):e0229460. doi: 10.1371/journal.pone.0229460. eCollection 2020.

Abstract

There is a limited evaluation of an independent linguistic battery for early diagnosis of Mild Cognitive Impairment due to Alzheimer's disease (MCI-AD). We hypothesized that an independent linguistic battery comprising of only the language components or subtests of popular test batteries could give a better clinical diagnosis for MCI-AD compared to using an exhaustive battery of tests. As such, we combined multiple clinical datasets and performed Exploratory Factor Analysis (EFA) to extract the underlying linguistic constructs from a combination of the Consortium to Establish a Registry for Alzheimer's disease (CERAD), Wechsler Memory Scale (WMS) Logical Memory (LM) I and II, and the Boston Naming Test. Furthermore, we trained a machine-learning algorithm that validates the clinical relevance of the independent linguistic battery for differentiating between patients with MCI-AD and cognitive healthy control individuals. Our EFA identified ten linguistic variables with distinct underlying linguistic constructs that show Cronbach's alpha of 0.74 on the MCI-AD group and 0.87 on the healthy control group. Our machine learning evaluation showed a robust AUC of 0.97 when controlled for age, sex, race, and education, and a clinically reliable AUC of 0.88 without controlling for age, sex, race, and education. Overall, the linguistic battery showed a better diagnostic result compared to the Mini-Mental State Examination (MMSE), Clinical Dementia Rating Scale (CDR), and a combination of MMSE and CDR.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Alzheimer Disease / complications*
  • Case-Control Studies
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / etiology
  • Female
  • Humans
  • Linguistics / methods*
  • Machine Learning*
  • Male
  • Neuropsychological Tests

Grants and funding

This study was funded in part by the Department of Psychiatry and Behavioral Sciences, James H. Quillen College of Medicine, East Tennessee State University. No additional external funding was received for this study.