Pragmatic Aspects of Discourse Production for the Automatic Identification of Alzheimer's Disease

Clinical literature provides convincing evidence that language deficits in Alzheimer's disease (AD) allow for distinguishing patients with dementia from healthy subjects. Currently, computational approaches have widely investigated lexicosemantic aspects of discourse production, while pragmatic aspects like cohesion and coherence, are still mostly unexplored. In this article, we aim at providing a more comprehensive characterization of language abilities for the automatic identification of AD in narrative description tasks by also incorporating pragmatic aspects of speech production. To this end, we investigate the relevance of a recently proposed set of pragmatic features extracted from an automatically generated topic hierarchy graph in combination with a complementary set of state-of-the-art features encoding lexical, syntactic and semantic cues. Experimental results on the DementiaBank corpus show an accuracy improvement from 82.6% to 85.5% in identifying AD patients when pragmatic features are incorporated to the set of lexicosemantic features. Nevertheless, these results are obtained relying on manual transcriptions, which strongly limits the applicability of computational analysis to clinical settings. Thus, in this work we additionally carry out an analysis of the errors introduced by a speech recognition system and the way in which they impact the performance of the proposed method. In spite of the high word error rates obtained on these data (∼40%), automatic AD identification accuracy decreased only to 79.7%, which is considered a remarkable result when compared with solutions based on manual transcriptions.