Applications of artificial

intelligence to aid early

detection of dementia: A
scoping review on current
capabilities and future
directions
Renjie Li, Xinyi Wang, Katherine Lawler, Saurabh Garg, Quan Bai , Jane Alty
Background & Objective
Aging Population Early Detection Current Detection
Limitations
The article discusses the Alzheimer's disease (AD) Current detection methods
urgent need for cost- has a 10–20 year pre- are mainly through
effective, objective clinical period before cognitive tests and specialist
biomarkers to detect early- significant cognitive scans, which are either time-
stage dementia, particularly decline. Risk factor consuming, insensitive to
Alzheimer's disease (AD), modification could prevent early stages, or too
due to the aging population 40% of cases and drug trials invasive/expensive for
and the long 'pre-clinical' would have greater chances widespread use. AI shows
period before significant of success if participants are promise in aiding early
cognitive decline. recruited at an earlier detection.
stage.
Methods & Materials
• A scoping review was conducted using
PubMed and IEEE Xplore databases,
filtering articles published within five
years and written in English, resulting
in 177 studies for analysis.
Current cognitive tests
• MMSE
• ACR-R
• MoCA
• CLOCK DRAWING TEST
Mini-Mental State
Examination (MMSE)
Duration: 6-10 minutes
Score: Out of 30
Measures: Memory, orientation, language, attention,
visuospatial function
Validation: Translated and validated in multiple regions
Specificity: Approximately 0.80-0.90 for detecting Alzheimer’s
Disease (AD)
Sensitivity: Low, especially for early-stage dementia
Challenges: Difficulty in setting a threshold cutoff score for
high sensitivity and specificity
Addenbrooke's Cognitive
Examination-Revised
(ACE-R)
Duration: 15-20 minutes
Measures: Attention, memory, fluency, language,
visuospatial function
Sensitivity: 84%-94%
Specificity: 89%
MoCA (Montreal Cognitive
Assessment)

Duration: 8-15 minutes

Measures: Short-term memory, visuospatial
function, executive function, fluency, attention,
language
Sensitivity: 84%-85%
Specificity: 87%
Clock Drawing Test

Duration: 1-5 minutes

Measures: Executive, spatial, visuo-
constructive cognitive functions
Sensitivity: 86%
Specificity: 83.5%
 AI-Based Tests

• The review categorizes AI-based tests into

computerized cognitive tests, movement tests,
speech, conversation, and language tests, and
computer-assisted interpretation of brain scans,
highlighting their potential in enhancing
dementia screening.
Computerized Cognitive Tests
User-Directed Tests: These tests are designed to be user-directed, which
helps in reducing costs and improving accessibility.
CogState & CANTAB Batteries: The CogState Battery assesses various
cognitive functions, correlating well with traditional neuropsychological
measures. The CANTAB Battery is sensitive and specific for detecting
MCI and dementia.
MoCA-CC: This computerized version of MoCA effectively distinguishes
MCI from normal cognition with high sensitivity and specificity.
Movement Analysis: Techniques like computer-based clock drawing, gait
analysis with accelerometers, and hand movement analysis using magnetic
sensors and deep learning models are employed to identify early markers of
dementia.
Computerized Cognitive Tests
Machine Learning in Tests: Computer-based clock drawing tests using
machine learning methods have been developed, showing good sensitivity
and specificity but requiring a tablet for use.
Gait Analysis: Utilizing wearable accelerometers to analyze walking
patterns, identifying features like pace and asymmetry to distinguish
between Alzheimer’s disease (AD) and Parkinson’s disease dementia.
Hand Movement Analysis: Applying magnetic sensor-based devices and
deep learning models to assess finger-tapping and hand trajectory, aiding in
the screening for dementia.
Computer-Assisted Graphic Drawings and
Handwriting Tests as well as Eye Movement
Tests for early detection of dementia

Variation and Errors in Hand Motor Function:

1. Individuals with AD and MCI exhibit greater variation and errors in hand motor
function compared to healthy subjects.
2. Features like pause time per stroke and stroke orientation control are
analyzed.
Eye-Tracking Techniques:
Researchers have used eye-tracking techniques to distinguish between different
groups:
1. Healthy individuals
2. Those with Subjective Cognitive Impairment (SCI)
3. Those with MCI
Language-Independent Tests:
3. These tests are designed to be language-independent, making them accessible
globally.
4. However, they require additional equipment.
5. Currently, they are still in the early stages of research.
Speech, Conversation, and Language Tests
Acoustic and Picture Description Conversational
Linguistic Tests Speech Analysis
Features
Interviews generate
AI analyzes both the Participants describe
speech data, which is
sound (acoustic a picture; features
analyzed using
features like MFCC, extracted from their
machine learning to
speech rate) and speech are used to
distinguish between
content (linguistic classify dementia
controls and dementia
features like with an accuracy of
with an accuracy of
vocabulary, grammar) up to 81.9%.
up to 90.0%.
of speech.
Computer-Assisted Interpretation of
Brain Scans
1 MRI & CT Scans
Used to support dementia diagnosis by
revealing structural brain changes.
3 Machine Learning
Various models have been applied to
classify dementia stages, but with limited
success in early detection.
2 PET Scans
Provide functional information and measure
abnormal proteins, but are expensive and
less accessible.
4 Deep Learning
Shows more promise, with techniques like
CNN models achieving higher accuracy in
distinguishing dementia types and stages.
Future directions: combining AI methods and
smart environments

Smart Wandering Movement Activity

Environments Pattern Analysis Recognition
Detection
These environments use Techniques like GMM
Studies have used Researchers have set
AI-driven sensors to clustering, Fisher vectors, and
machine learning to up smart
monitor daily activities multiclass SVM models have
analyze movement environments for
without the limitations been used to classify activities
data from sensors to early dementia
of wearable sensors. with an average recall and
detect wandering detection by
They can be precision of 82% in a study
behaviors, a sign of analyzing localization
categorized into real- involving 98 participants. This
early dementia, with and movement using
life monitoring and approach aids in recognizing
varying degrees of various sensors.
scenario-based daily activities that may
success.
monitoring. indicate cognitive disorders.
Conclusions
Promising AI Techniques
AI techniques show promise in
improving the accuracy and
automation of dementia screening.
Future Directions
The article suggests that smart
environments and multi-modal tests
could be future directions for early
detection of dementia.

Limitations
The review did not account for the impact of varying experiment designs, which
could bias the results. It also focused mainly on classification accuracies without
considering the time or economic costs of new AI technologies.