# Zero-Shot Cognitive Impairment Detection from Speech Using AudioLLM

arXiv: https://arxiv.org/abs/2506.17351 · HTML: https://mlsanity.com/paper/2506.17351/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 28 of its 50 references that are in the map.
- First posted on arXiv 20 Jun 2025.

## Builds on (most cited first, 28 of 28)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Judging LLM-as-a-Judge with MT-Bench and Chatbot Arena](https://mlsanity.com/paper/2306.05685/) (2023)
- [Qwen2.5 Technical Report](https://mlsanity.com/paper/2412.15115/) (2024)
- [Neural Machine Translation by Jointly Learning to Align and Translate](https://mlsanity.com/paper/1409.0473/) (2014)
- [Robust Speech Recognition via Large-Scale Weak Supervision](https://mlsanity.com/paper/2212.04356/) (2022)
- [wav2vec 2.0: A Framework for Self-Supervised Learning of Speech Representations](https://mlsanity.com/paper/2006.11477/) (2020)
- [Qwen Technical Report](https://mlsanity.com/paper/2309.16609/) (2023)
- [HuBERT: Self-Supervised Speech Representation Learning by Masked Prediction of Hidden Units](https://mlsanity.com/paper/2106.07447/) (2021)
- [WavLM: Large-Scale Self-Supervised Pre-Training for Full Stack Speech Processing](https://mlsanity.com/paper/2110.13900/) (2021)
- [Enriching Word Vectors with Subword Information](https://mlsanity.com/paper/1607.04606/) (2016)
- [Qwen-Audio: Advancing Universal Audio Understanding via Unified Large-Scale Audio-Language Models](https://mlsanity.com/paper/2311.07919/) (2023)
- [SALMONN: Towards Generic Hearing Abilities for Large Language Models](https://mlsanity.com/paper/2310.13289/) (2023)
- [BEATs: Audio Pre-Training with Acoustic Tokenizers](https://mlsanity.com/paper/2212.09058/) (2022)
- [VoiceBench: Benchmarking LLM-Based Voice Assistants](https://mlsanity.com/paper/2410.17196/) (2024)
- [AudioBench: A Universal Benchmark for Audio Large Language Models](https://mlsanity.com/paper/2406.16020/) (2024)
- [WavLLM: Towards Robust and Adaptive Speech Large Language Model](https://mlsanity.com/paper/2404.00656/) (2024)
- [Alzheimer's Dementia Recognition through Spontaneous Speech: The ADReSS Challenge](https://mlsanity.com/paper/2004.06833/) (2020)
- [Diagnostic Reasoning Prompts Reveal the Potential for Large Language Model Interpretability in Medicine](https://mlsanity.com/paper/2308.06834/) (2023)
- [A Survey on Speech Large Language Models for Understanding](https://mlsanity.com/paper/2410.18908/) (2024)
- [To BERT or Not To BERT: Comparing Speech and Language-based Approaches for Alzheimer's Disease Detection](https://mlsanity.com/paper/2008.01551/) (2020)
- [Artificial Intelligence, speech and language processing approaches to monitoring Alzheimer's Disease: a systematic review](https://mlsanity.com/paper/2010.06047/) (2020)
- [Multi-modal fusion with gating using audio, lexical and disfluency features for Alzheimer's Dementia recognition from spontaneous speech](https://mlsanity.com/paper/2106.09668/) (2021)
- [Connected Speech-Based Cognitive Assessment in Chinese and English](https://mlsanity.com/paper/2406.10272/) (2024)
- [Better Word Embeddings by Disentangling Contextual n-Gram Information](https://mlsanity.com/paper/1904.05033/) (2019)
- [Early Dementia Detection Using Multiple Spontaneous Speech Prompts: The PROCESS Challenge](https://mlsanity.com/paper/2412.15230/) (2024)
- [Cognitive Insights Across Languages: Enhancing Multimodal Interview Analysis](https://mlsanity.com/paper/2406.07542/) (2024)

## Built on by (most cited first, 2 of 2)

- [Zero-Shot Parkinson's Disease Detection from Speech: Comparing Large Audio and Language Models](https://mlsanity.com/paper/2605.24806/) (2026)
- [Toward Generalizable Cognitive Impairment Detection with Speech-Based Multimodal Large Language Models](https://mlsanity.com/paper/2607.21496/) (2026)

## Abstract (arXiv)

Cognitive impairment (CI) is of growing public health concern, and early detection is vital for effective intervention. Speech has gained attention as a non-invasive and easily collectible biomarker for assessing cognitive decline. Traditional CI detection methods typically rely on supervised models trained on acoustic and linguistic features extracted from speech, which often require manual annotation and may not generalise well across datasets and languages. In this work, we propose the first zero-shot speech-based CI detection method using the Qwen2- Audio AudioLLM, a model capable of processing both audio and text inputs. By designing prompt-based instructions, we guide the model in classifying speech samples as indicative of normal cognition or cognitive impairment. We evaluate our approach on two datasets: one in English and another multilingual, spanning different cognitive assessment tasks. Our results show that the zero-shot AudioLLM approach achieves performance comparable to supervised methods and exhibits promising generalizability and consistency across languages, tasks, and datasets.