Using Discourse Analysis To Assess Cognitive Decline

Figure from Gauthier et al. (2005).


Alzheimer's Disease (AD) in addition to other dementias are progressive neurodegenerative weather condition that unfold over time. Subtle symptoms such as forgetfulness in addition to word finding problems may progress to mild cognitive impairment (MCI), in addition to thus escalate to full-blown dementia. Recent efforts to dissever prodromal states have got included automated analysis of spontaneous speech, which loses complexity as the illness progresses.

In 1 study, Frazier Fraser et al. (2015) applied machine learning methods to spoken communication transcripts in addition to good files from the DementiaBank database. The participants were 167 patients amongst likely AD in addition to 97 controls. The authors considered a amount of 370 linguistic features, in addition to establish that a subset of 35 was able to dissever patients vs. controls amongst 82% accuracy.1 While an advance over previous studies, this is non yet useful for diagnostic purposes. Another limitation was the relatively curt length of the spoken communication samples.2

Using element analysis, the researchers establish that four dimensions of speech3 were most indicative of dementia:
  • Semantic impairmentusing overly unproblematic words
  • Acoustic price e.g., speaking to a greater extent than piece of cake
  • Syntactic impairment  using less complex grammer
  • Information price not clearly identifying the primary aspects of a pic they were told to describe

Public figures who give repeated interviews leave of absence a searchable tape of spontaneous spoken communication that tin travel analyzed for changes over time. Presidential press conferences render some other rich root of information for linguistic analysis.

Berisha et al. (2015) examined transcripts from the press conferences given past times Ronald Reagan (1981-1989) in addition to George H.W. Bush (1989-1993). We know that President Reagan received a formal diagnosis of Alzheimer's illness inwards 1994, 5 years afterwards leaving office. And as far as nosotros know, the elderberry Bush is yet cognitively intact for his historic menses (he's 92 now).

The quantified linguistic features included:
  • Number of unique words
  • Non-specific nouns – e.g., thing, something, anything
  • Filler words – well, so, basically, actually, literally, um, ah
  • Low-imageability, high frequency verbs – e.g., get, give, go, have, do

Reagan showed a important refuse inwards the release of unique words over the course of study of his presidency, only Bush did not.



Likewise, Reagan showed a important increase inwards the usage of non-specific nouns in addition to fillers, only Bush did not.



There are several caveats here. Reagan was 69 when he was elected, spell Bush was 64. Reagan was president for viii years in addition to Bush for exclusively iv years; yet Bush held over twice as many press conferences as Reagan. Nonetheless, the results are consistent amongst a refuse inwards cognitive portion (which is non uncommon when aging from 69 to 77). Can nosotros tin dissever Reagan as having MCI on the footing of these results? I don't recall so. We'd genuinely require comparable information from a population of demographically matched elderly participants.


President Donald Trump

After his Feb. sixteen press conference, the populace debate over whether President Trump is mentally unbalanced has intensified. Much of the electrical flow in addition to past times word has centered on the possibility of Narcissistic Personality Disorder (NPD), as speculated inwards The Atlantic in addition to Vanity Fair in addition to The Guardian. Sure, Trump has many of these qualities (that predate his actual grandiose status as POTUS):
  1. Grandiosity amongst expectations of superior handling from others
  2. Fixated on fantasies of power, success, intelligence, attractiveness, etc.
  3. Self-perception of beingness unique, superior in addition to associated amongst high-status people in addition to institutions
  4. Needing constant admiration from others
  5. Sense of entitlement to especial handling in addition to to obedience from others
  6. Exploitative of others to attain personal gain
  7. Unwilling to sympathise amongst others' feelings, wishes, or needs
  8. Intensely envious of others in addition to the belief that others are as envious of them
  9. Pompous in addition to arrogant demeanor
And nosotros tin telephone band him narcissistic inwards the generic sense of the word. But practise nosotros require to diagnose him amongst a quasi-psychiatric disorder, as inwards this NY Times letter signed past times 35 mental wellness professionals?4
Mr. Trump’s spoken communication in addition to actions demonstrate an inability to tolerate views dissimilar from his own, leading to rage reactions. His words in addition to behavior advise a profound inability to empathize. Individuals amongst these traits distort reality to accommodate their psychological state, attacking facts in addition to those who bring them (journalists, scientists).

In a powerful leader, these attacks are likely to increase, as his personal myth of greatness appears to travel confirmed. We believe that the grave emotional instability indicated past times Mr. Trump’s spoken communication in addition to actions makes him incapable of serving safely as president.

Dr. Allen Frances, chair of the DSM-IV chore force, has four dimensions of speech3 were most indicative of dementia:
  • Semantic impairmentusing overly unproblematic words
  • Acoustic price e.g., speaking to a greater extent than piece of cake
  • Syntactic impairment  using less complex grammer
  • Information price not clearly identifying the primary aspects of a pic they were told to describe

Public figures who give repeated interviews leave of absence a searchable tape of spontaneous spoken communication that tin travel analyzed for changes over time. Presidential press conferences render some other rich root of information for linguistic analysis.

Berisha et al. (2015) examined transcripts from the press conferences given past times Ronald Reagan (1981-1989) in addition to George H.W. Bush (1989-1993). We know that President Reagan received a formal diagnosis of Alzheimer's illness inwards 1994, 5 years afterwards leaving office. And as far as nosotros know, the elderberry Bush is yet cognitively intact for his historic menses (he's 92 now).

The quantified linguistic features included:
  • Number of unique words
  • Non-specific nouns – e.g., thing, something, anything
  • Filler words – well, so, basically, actually, literally, um, ah
  • Low-imageability, high frequency verbs – e.g., get, give, go, have, do

Reagan showed a important refuse inwards the release of unique words over the course of study of his presidency, only Bush did not.



Likewise, Reagan showed a important increase inwards the usage of non-specific nouns in addition to fillers, only Bush did not.



There are several caveats here. Reagan was 69 when he was elected, spell Bush was 64. Reagan was president for viii years in addition to Bush for exclusively iv years; yet Bush held over twice as many press conferences as Reagan. Nonetheless, the results are consistent amongst a refuse inwards cognitive portion (which is non uncommon when aging from 69 to 77). Can nosotros tin dissever Reagan as having MCI on the footing of these results? I don't recall so. We'd genuinely require comparable information from a population of demographically matched elderly participants.


President Donald Trump

After his Feb. sixteen press conference, the populace debate over whether President Trump is mentally unbalanced has intensified. Much of the electrical flow in addition to past times word has centered on the possibility of Narcissistic Personality Disorder (NPD), as speculated inwards The Atlantic in addition to Vanity Fair in addition to The Guardian. Sure, Trump has many of these qualities (that predate his actual grandiose status as POTUS):
  1. Grandiosity amongst expectations of superior handling from others
  2. Fixated on fantasies of power, success, intelligence, attractiveness, etc.
  3. Self-perception of beingness unique, superior in addition to associated amongst high-status people in addition to institutions
  4. Needing constant admiration from others
  5. Sense of entitlement to especial handling in addition to to obedience from others
  6. Exploitative of others to attain personal gain
  7. Unwilling to sympathise amongst others' feelings, wishes, or needs
  8. Intensely envious of others in addition to the belief that others are as envious of them
  9. Pompous in addition to arrogant demeanor
And nosotros tin telephone band him narcissistic inwards the generic sense of the word. But practise nosotros require to diagnose him amongst a quasi-psychiatric disorder, as inwards this forcefully argued that Trump does non run into criteria for NPD, because he is non distressed past times his behavior:
Mr. Trump causes severe distress rather than experiencing it in addition to has been richly rewarded, rather than punished, for his grandiosity, self-absorption in addition to lack of empathy. It is a stigmatizing insult to the mentally sick (who are to a greater extent than oft than non good behaved in addition to good meaning) to travel lumped amongst Mr. Trump (who is neither).

Discourse Analysis

Here I'll advise a dissimilar approach: tin nosotros quantify age-related neurological alter using spontaneous speech?



“You know what uranium is, right?  It's this thing called nuclear weapons in addition to other things.  Like, lots of things are done amongst uranium, including some bad things.  Nobody talks nigh that.  I didn't do anything for Russia.  I've done nothing for Russia.”

This is the most egregious illustration inwards the 1 hour, 17 infinitesimal train wreck. But at that topographic point are other signs. He used the structure “very, very” xx times. The word “thing” (and its variants) was uttered 102 times.

Am I going to diagnose him amongst anything? Of course of study not. That's unethical! But I volition say that since Mr. Trump has been a populace figure for nearly twoscore years, nosotros tin objectively analyze his spontaneous spoken communication in addition to quantify whatever changes over time. I must emphasize that at that topographic point is no magical scale to usage for classification or comparing purposes (at to the lowest degree non yet). We don't know what's normal age-related refuse in addition to what's pathological.

I advise that the best corpus of spontaneous spoken communication information is the collection of Trump interviews/conversations amongst David Letterman. I believe they're unscripted, in addition to at that topographic point are many many of them on YouTube (I've linked to viii below). Letterman has aged too, thus you lot mightiness as good analyze his spoken communication as well.





Footnotes

1 The authors performed...
...a 10-fold cross-validation physical care for inwards which a unique 10% of the information (i.e., the ‘test set’) are used inwards each iteration for evaluation, in addition to the remaining 90% (i.e., the ‘training set’) are used to select the most useful features (of the 370 available as described inwards “Features” above) in addition to ready our models. The reported accuracy is an average across the 10 folds. In a given fold, information from whatever private speaker tin laissez passer on inwards the bear witness laid or the preparation set, only non both.
2 Influenza A virus subtype H5N1 show-stopping limitation is that the ii groups were non matched for historic menses or education. The hateful historic menses was 71.8 for AD vs. 65.2 for controls, in addition to years of educational activity 12.5 vs. 14.1 yrs.

3 See also Alzheimer’s Disease Markers Found inwards Speech Patterns (link via @aholdenj).

4 BTW, they're non supposed to diagnose non-patients, that's unethical.


References

Berisha V, Wang S, LaCross A, & Liss J (2015). Tracking discourse complexity preceding Alzheimer's illness diagnosis: a instance study comparing the press conferences of Presidents Ronald Reagan in addition to George Herbert Walker Bush. Journal of Alzheimer's Disease, 45 (3), 959-63 PMID: 25633673

Fraser, K., Meltzer, J., & Rudzicz, F. (2015). Linguistic Features Identify Alzheimer’s Disease inwards Narrative Speech. Journal of Alzheimer's Disease, 49 (2), 407-422 DOI: 10.3233/JAD-150520

Gauthier S, Reisberg B, Zaudig M, Petersen RC, Ritchie K, Broich K, Belleville S, Brodaty H, Bennett D, Chertkow H, Cummings JL. (2006). Mild cognitive impairment. The Lancet  367:1262-70.

Thomas, C., Keselj, V., Cercone, N., Rockwood, K., & Asp, E. (2005). Automatic detection in addition to rating of dementia of Alzheimer type through lexical analysis of spontaneous speech. IEEE International Conference, 3, 1569-1574. doi: 10.1109/ICMA.2005.1626789


ADDENDUM (May 23 2017): I updated some of the dead video links. Also, ii novel posts have got appeared today: Trump wasn’t e'er thus linguistically challenged. What could explicate the change? (by Sharon Begley at STAT) in addition to Donald Trump: Cognitive refuse or TDS? (by Mark Liberman at Language Log).


ADDENDUM #2 (Sept xxx 2017): I updated the embedded video, only many of the novel YouTube links have got been taken down.


ADDENDUM #3 (Jan half-dozen 2018): I 1 time to a greater extent than updated many of the novel YouTube links.


Donald Trump on the David Letterman Show

11-10-1988 Letterman Donald Trump [corrected 9-30-17]

Donald Trump Interview on Letterman Show (1997) [corrected]

Donald Trump Interview on David Letterman Show (1998) [corrected]

Donald Trump on David Letterman Show (2008-08-08) [dead link]

Donald Trump talks draw organization in addition to banks on David Letterman Show (2009-02-18) [corrected]

Donald Trump on David Letterman Show (2010) [corrected]

Donald Trump on David Letterman 17 October, 2013 Full Interview

Donald Trump on David Letterman Jan eighth 2015 Full Interview [corrected]

You tin bring out them all here here.


other Trump

The Trump Archive - over 900 televised speeches, interviews, debates, in addition to other intelligence broadcasts related to President Donald Trump. See postal service at Internet Archive.

Donald Trump 1980 Interview (Brokaw) [corrected]


Ronald Reagan videos

The President's News Conference - 1/29/81

The President's News Conference - 8/12/86

Iran/Contra Excerpt from 11/19/86

The President's News Conference - tardily Oct 1987
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