Predicting Cognitive Impairment in Cerebrovascular Disease Using Spoken Discourse Production

Angela Roberts*, Katharine Aveni, Shalane Basque, Joseph B. Orange, Paula McLaughlin, Joel Ramirez, Angela K. Troyer, Stephanie Gutierrez, Angie Chen, Robert Bartha, Malcolm A. Binns, Sandra E. Black, Leanne K. Casaubon, Dar Dowlatshahi, Ayman Hassan, Donna Kwan, Brian Levine, Jennifer Mandzia, Demetrios J. Sahlas, Christopher J.M. ScottStephen Strother, Kelly M. Sunderland, Sean Symons, Richard Swartz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Purpose: Dementia due to cerebrovascular disease (CVD) is common. Detecting early cognitive decline in CVD is critical because addressing risk factors may slow or prevent dementia. This study used a multidomain discourse analysis approach to determine the spoken language signature of CVD-related cognitive impairment. Method: Spoken language and neuropsychological assessment data were collected prospectively from 157 participants with CVD as part of the Ontario Neurodegenerative Disease Research Initiative, a longitudinal, observational study of neurodegenerative disease. Participants were categorized as impaired (n = 92) or cognitively normal for age (n = 65) based on neuropsychology criteria. Spoken language samples were transcribed orthographically and annotated for 13 discourse features, across five domains. Discriminant function analyses were used to determine a minimum set of discourse variables, and their estimated weights, for maximizing diagnostic group separation. Results: The optimal discriminant function that included 10 of 13 discourse measures correctly classified 78.3% of original cases (69.4% cross-validated cases) with a sensitivity of 77.2% and specificity of 80.0%. Conclusion: Spoken discourse appears to be a sensitive measure for detecting cognitive impairment in CVD with measures of productivity, information content, and information efficiency heavily weighted in the final algorithm.

Original languageEnglish (US)
Pages (from-to)73-98
Number of pages26
JournalTopics in Language Disorders
Issue number1
StatePublished - Jan 2021


  • assessment
  • biomarker
  • cerebrovascular disease (CVD)
  • cognition
  • dementia
  • multilevel discourse analysis
  • neurodegeneration
  • spoken discourse
  • spoken language
  • vascular cognitive impairment (VCI)

ASJC Scopus subject areas

  • Language and Linguistics
  • Linguistics and Language
  • Speech and Hearing


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