# Cog-TiPRO: Iterative Prompt Refinement with LLMs to Detect Cognitive Decline via Longitudinal Voice Assistant Commands

arXiv: https://arxiv.org/abs/2505.17137 · HTML: https://mlsanity.com/paper/2505.17137/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 16 of its 31 references that are in the map.
- First posted on arXiv 22 May 2025.

## Builds on (most cited first, 16 of 16)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
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- [Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks](https://mlsanity.com/paper/1908.10084/) (2019)
- [Qwen Technical Report](https://mlsanity.com/paper/2309.16609/) (2023)
- [Scaling Instruction-Finetuned Language Models](https://mlsanity.com/paper/2210.11416/) (2022)
- [HuBERT: Self-Supervised Speech Representation Learning by Masked Prediction of Hidden Units](https://mlsanity.com/paper/2106.07447/) (2021)
- [ChatGLM: A Family of Large Language Models from GLM-130B to GLM-4 All Tools](https://mlsanity.com/paper/2406.12793/) (2024)
- [iTransformer: Inverted Transformers Are Effective for Time Series Forecasting](https://mlsanity.com/paper/2310.06625/) (2023)
- [Automatic Prompt Optimization with "Gradient Descent" and Beam Search](https://mlsanity.com/paper/2305.03495/) (2023)
- [Optimizing Instructions and Demonstrations for Multi-Stage Language Model Programs](https://mlsanity.com/paper/2406.11695/) (2024)
- [Multilingual Alzheimer's Dementia Recognition through Spontaneous Speech: a Signal Processing Grand Challenge](https://mlsanity.com/paper/2301.05562/) (2023)
- [Exploiting Longitudinal Speech Sessions via Voice Assistant Systems for Early Detection of Cognitive Decline](https://mlsanity.com/paper/2410.12885/) (2024)
- [Profiling Patient Transcript Using Large Language Model Reasoning Augmentation for Alzheimer's Disease Detection](https://mlsanity.com/paper/2409.12541/) (2024)
- [UMB@PerAnsSumm 2025: Enhancing Perspective-Aware Summarization with Prompt Optimization and Supervised Fine-Tuning](https://mlsanity.com/paper/2503.11118/) (2025)
- [Unveil Multi-Picture Descriptions for Multilingual Mild Cognitive Impairment Detection via Contrastive Learning](https://mlsanity.com/paper/2505.17067/) (2025)

## Abstract (arXiv)

Early detection of cognitive decline is crucial for enabling interventions that can slow neurodegenerative disease progression. Traditional diagnostic approaches rely on labor-intensive clinical assessments, which are impractical for frequent monitoring. Our pilot study investigates voice assistant systems (VAS) as non-invasive tools for detecting cognitive decline through longitudinal analysis of speech patterns in voice commands. Over an 18-month period, we collected voice commands from 35 older adults, with 15 participants providing daily at-home VAS interactions. To address the challenges of analyzing these short, unstructured and noisy commands, we propose Cog-TiPRO, a framework that combines (1) LLM-driven iterative prompt refinement for linguistic feature extraction, (2) HuBERT-based acoustic feature extraction, and (3) transformer-based temporal modeling. Using iTransformer, our approach achieves 73.80% accuracy and 72.67% F1-score in detecting MCI, outperforming its baseline by 27.13%. Through our LLM approach, we identify linguistic features that uniquely characterize everyday command usage patterns in individuals experiencing cognitive decline.