Zero-Shot Cognitive Impairment Detection from Speech Using AudioLLM

Abstract: 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.