Linguistic Indicators of Early Cognitive Decline in the DementiaBank Pitt Corpus: A Statistical and Machine Learning Study

Abstract

Background: Subtle changes in spontaneous language production are among the earliest indicators of cognitive decline. Identifying linguistically interpretable markers of dementia can support transparent and clinically grounded screening approaches. Methods: This study analyzes spontaneous speech transcripts from the DementiaBank Pitt Corpus using three linguistic representations: raw cleaned text, a part-of-speech (POS)-enhanced representation combining lexical and grammatical information, and a POS-only syntactic representation. Logistic regression and random forest models were evaluated under two protocols: transcript-level train-test splits and subject-level five-fold cross-validation to prevent speaker overlap. Model interpretability was examined using global feature importance, and statistical validation was conducted using Mann-Whitney U tests with Cliff's delta effect sizes. Results: Across representations, models achieved stable performance, with syntactic and grammatical features retaining strong discriminative power even in the absence of lexical content. Subject-level evaluation yielded more conservative but consistent results, particularly for POS-enhanced and POS-only representations. Statistical analysis revealed significant group differences in functional word usage, lexical diversity, sentence structure, and discourse coherence, aligning closely with machine learning feature importance findings. Conclusion: The results demonstrate that abstract linguistic features capture robust markers of early cognitive decline under clinically realistic evaluation. By combining interpretable machine learning with non-parametric statistical validation, this study supports the use of linguistically grounded features for transparent and reliable language-based cognitive screening.