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

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: arxiv.org/abs/2602.13047
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Arxiv announce type: replace
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
arXiv id: 2602.13047
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Categories: cs.CL, cs.AI
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
PDF: arxiv.org/pdf/2602.13047
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Primary category: cs.CL
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Published: 11 Sept 2026
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh

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9

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T19

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2 h ago

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Authors: Madhurananda Pahar, Caitlin Illingworth, Dorota Braun

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Value	Valid from → to	Status	Source	Confidence	Extractor
2602.13047	11 Sept 2026 21:03 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

Claims are temporal and append-only: a new observation closes the previous claim (valid_to) instead of overwriting it. Conflicting claims from different sources are kept side by side and flagged — never averaged. Methodology →

11 Sept 2026
New paperPaperFalse positive bias in AI-powered speech-based cognitive screening for multilingual English speakers in the UK
New paper: False positive bias in AI-powered speech-based cognitive screening for multilingual English speakers in the UK
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Source documents
Source	Document	Type	Tier	Last observed	Snapshots
arXiv (Atom API + RSS)	rss.arxiv.org/rss/cs.AI	feed	T1· Official	2 min ago	1

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