Task-Centric Multimodal Learning for Cognitive Impairment Detection

Abstract

Dementia affects millions of older adults worldwide, yet early detection remains difficult outside clinical settings. Traditional models primarily rely on text or voice-based responses, capturing only a limited view of human cognition despite the inherently multimodal nature of human expression. This work proposes a contactless, multimodal screening framework that leverages video, audio, and text signals collected during structured voice-based interactions with Amazon Alexa. By incorporating these modalities, our approach captures a more holistic representation of human behavior encompassing speech patterns, vocal characteristics, facial expressions, and linguistic structure, which may enable more accurate detection of cognitive decline. Different participants completed three conversational tasks designed to probe spontaneous speech, comprehension, and recall. We pursued three objectives: (1) evaluate which of the three Alexa tasks provides the most informative cognitive signals, (2) compare the effectiveness of unimodal models, and (3) assess the benefits of multimodal fusion models. Task-level analysis shows that the video model achieves its best performance on Command-Reading, with an accuracy of 0.65 (AUC 0.69), while the audio model performs best on Question-Answering, reaching an accuracy of 0.67 (AUC 0.73). In contrast, the multimodal model demonstrates consistently stable performance across tasks, achieving an accuracy of 0.76 (AUC 0.75) on Command-Reading and 0.76 (AUC 0.73) on Question-Answering. These findings demonstrate that multimodal behavioral cues captured through naturalistic interactions can reliably distinguish MCI from healthy aging, highlighting the limitations of traditional diagnostic paradigms and supporting the shift toward multimodal, real-world cognitive assessment frameworks.