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False positive bias in AI-powered speech-based cognitive screening for multilingual English speakers in the UK

arxiv.org/abs/2602.13047

Updated 51 min ago · first seen 11 Sept 2026

paper_01M294GPV20TA99D9QT6E0WD22

Published
11 Sept 2026
T1 · 51 min ago
arXiv
2602.13047
T1 · 51 min ago
Category
cs.CL
T1 · 51 min ago

Abstract

-cross Abstract: Conversational speech reveals early signs of cognitive decline, including dementia and mild cognitive impairment (MCI). AI models show promise for speech-based screening, yet most research focuses on monolingual groups. In the UK, dementia is projected to rise fastest among Black and Asian communities, where multilingualism is common, making equity assessment critical. We recruited 1,395 participants (monolingual English speakers and multilingual speakers from Sheffield/Bradford) and collected over 263 hours of speech via the CognoMemory agent. Multilingual participants spoke English alongside Somali, Chinese, or South Asian languages (Hindi, Urdu, Punjabi, Mirpuri, Arabic). We evaluated ASR (Whisper, Wav2Vec 2.0, NeMo) and downstream AI models for cognitive classification and MMSE regression. ASR accuracy showed no significant differences across groups. However, downstream models exhibited systematic disparities: multilingual speakers were more often misclassified as impaired, especially in memory, fluency, and reading tasks. False-positive rates were substantially higher for multilingual (28 to 37%) than monolingual (12 to 16%) speakers, meaning multilingual individuals were approximately 2.5 times more likely to receive incorrect impairment labels. These biases worsened when models were trained on DementiaBank. This is the first large-scale analysis of false-positive bias in speech-based AI cognitive screening for UK multilingual ethnic minorities. Despite strong overall performance, current models show measurable disparities affecting multilingual speakers. Addressing these biases is essential for safe, equitable deployment in diverse healthcare settings.

Authors 7

Madhurananda Pahar, Caitlin Illingworth, Dorota Braun, Bahman Mirheidari, Lise Sproson, Daniel Blackburn, Heidi Christensen

Specification

Official page

Source:arXiv (Atom API + RSS)T1observed 51 min agohigh

Arxiv announce type
replace

Source:arXiv (Atom API + RSS)T1observed 51 min agohigh

arXiv id
2602.13047

Source:arXiv (Atom API + RSS)T1observed 51 min agohigh

Categories
cs.CL, cs.AI

Source:arXiv (Atom API + RSS)T1observed 51 min agohigh

PDF

Source:arXiv (Atom API + RSS)T1observed 51 min agohigh

Primary category
cs.CL

Source:arXiv (Atom API + RSS)T1observed 51 min agohigh

Published
11 Sept 2026

Source:arXiv (Atom API + RSS)T1observed 51 min agohigh

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Provenance

Attributed facts

9

Source tiers

T19

Freshest observation

51 min ago

Conflicts

None