인지적 노화와 말소리 음향학적 자질의 관련성
The Relationship between Cognitive Ageingand Speech Features
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
노년기 삶의 질을 중요한 변수의 하나는 ‘소통의 삶’일 것이다. 정상적인 노화(ageing)에서 경도인지장애(MCI)로 진행될 징후를 조기에 발견하는 것은 알츠하이머병(AD)과 같은 보다 심각한 치매로 진행되는 것을 사전에 예방할 수 있는 중요한 방책이다. 급증하는 노년기 인구와 비례하여 치매 발병율 또한 상당하기에 국내외적으로 조기 치매징후 감별도구 개발에 초점을 둔 생활 친화적인 융복합적 연구가 요구된다. 현재 일반적으로 진행되는 나이든 성인 및 노인에 대한 신경인지평가는 주의력, 기억력, 집행기능, 추론, 그리고 언어 능력 등과 같은 다양한 영역을 검사하고 정량화한다. 주로 연필과 종이를 사용하는 평가환경은 감별평가인 경우 비교적 짧은 시간(예:대략 15~30분)이 소요되기도 하며, 심화평가에서는 최대 몇 시간이 소요될 수 있다. 그리고 치매로 진행되는 지의 여부를 시간 흐름에 따라 모니터링하기 위해 반복적으로 재평가해야하는 부담이 있다. 종이 평가를 통해 치매의심 혹은 치매 초기가 진단 될 경우 치매의 확증과정도를 확인하기 위해 뇌 검사(예:CT, MRI)도 실시된다. 이러한 시간소요, 반복적인 재평가, 검사 비용 등은 개인 및 보호자에게 심리적 및 경제적 부담이 될 수 있다. 따라서, 이러한 부담감을 최소화 하면서 무엇보다 효율적으로 인지감퇴 이상적 징후를 확인할 수 있는 방안이 절실하다. 오랜 기간 초기 치매의 주요 증상인 구어산출 변화에 대해 지속적인 연구들이 진행되어 왔으며, 특히 말소리 자질에 대한 다각도적인 분석을 통해 MCI와 초기 AD, 그리고 정상 인지 노인들 간의 차이 증상들이 보고되었다. 최근에는 간편하게 치매 증상 유무를 확인할 수 있는 컴퓨터 기반의 말소리 자동분석과 구어인식 방법들이 활발해지고 있다. 이에 이 논문에서는 일반적인 노화의 인지적 더딤과 MCI 및 초기 AD 인지감퇴에 따른 말소리 자질의 변화를 알아보고, 자동구어분석 방식에 의한 말소리 자질 분석이 인지 퇴행을 구분하고 예측하는데 있어 지니는 임상적 의의를 살펴보고자 한다.
Abstract
One of the most important variables for the quality of life in old age will be ‘a life of communication’. Early detection of signs of progression from normal aging to mild cognitive impairment (MCI) is an important way to prevent progression to more serious dementias such as Alzheimer's disease (AD). Since the incidence of dementia is also significant in proportion to the rapidly increasing elderly population, life-friendly convergence research focusing on the development of tools to identify early signs of dementia at home and abroad is required. Neuropsychologic evaluation of older adults and the elderly, which is currently generally conducted, examines and quantifies various areas such as attention, memory, executive function, reasoning, and language ability. In an evaluation environment that mainly uses pencil and paper, the differential evaluation may take a relatively short time (eg, approximately 15 to 30 minutes), and the in-depth evaluation may take up to several hours. And there is the burden of repeated re-evaluation to monitor whether people are progressing to dementia over time. If dementia is suspected or early stage of dementia is diagnosed through paper evaluation, brain tests are also performed to confirm the confirmation and extent of dementia. Such time consuming, repeated re-evaluation, and examination costs can be psychological and economic burdens for individuals and their caregivers. Therefore, there is an urgent need for a method that can effectively identify the ideal symptom of cognitive decline while minimizing this burden. For a long time, continuous studies have been conducted on changes in speech production, a major symptom of early dementia, and in particular, through multi-faceted analysis of speech features, symptoms of differences between MCI, early AD, and normal cognitive elderly have been reported. Recently, computer-based automatic speech analysis and speech recognition methods that can easily check the presence or absence of dementia symptoms are becoming active. Therefore, in this paper, we examine the changes in speech features due to cognitive slowing in healthy aging and cognitive impairment in MCI and early AD, and examine the clinical significance of speech features by automatic speech analysis in classifying and predicting cognitive deterioration.
참고문헌 (33)
- 강동우, "알츠하이머병 환자의 뇌 영상 검사의 최신 지견과임상 적용 방법", 신경정신의학, 57(1), pp.12~22 (2018), 대한신경정신의학회[DOI]
- 강미애, "주관적 기억 장애와 경도 인지 장애의 신경인지기능 특성 비교", Annals of geriatric medicine and research, 18(1), pp.7~15 (2014), 대한노인병학회[DOI]
- 오응석, "경도인지장애", 대한신경과학회지, 34(3), pp.167~175 (2016), 대한신경과학회[DOI]
- 이미숙, "주관적 인지 저하의 인지-의사소통 예측인자: 체계적 고찰 및 메타분석", 특수교육재활과학연구, 61(1), pp.299~324 (2022), 특수교육재활과학연구소[DOI]
- Amunts, Julia, "Comprehensive verbal fluency features predict executive function performance", Scientific Reports, 11 (2021)
- Banovic, S, "Communication difficulties as a result of dementia", Mater Sociomed, 30(3) (2018)
- Bayles, Kathryn, "Cognitive-Communication Disorders of MCI and Dementia:Definition, Assessment, and Clinical Management" (2020), Plural Publishing Inc
- Beltrami, D., "Speech analysis by natural language processing techniques:A possible tool for very early detection of cognitive decline?", Frontiers in Aging Neuroscience, 13 (2018)
- Cabeza, Roberto, "Cognitive neuroscience of healthy aging : Maintenance, reserve, and compensation", Nature Reviews Neuroscience, 19(11) (2018)
- de la Fuente Garcia, Sofia, "Artificial Intelligence, Speech, and Language Processing Approaches to Monitoring Alzheimer’s Disease:A Systematic Review", Journal of Alzheimer Disease, 78(4)
- De Looze, Céline, "Cognitive and structural correlates of Conversational Speech Timing in Mild Cognitive Impairment and Mild-to-Moderate Alzheimer’s Disease : Relevance for Early Detection Approaches", Frotiers in Ageing Science, 13 (2021)
- Farias, S. T., "Progression of mild cognitive impairment to dementia in clinic-vs community-based cohorts", Arch Neurol, 66 (2009)
- Folstein, M. F., "Mini-Mental State:A practical method for grading the cognitive state of patients for the clinician", Journal of Psychiatric Research, 12 (1975)
- Murman, D. L., "The Impact of Age on Cognition", Seminars in Hearing, 36(3) (2015)
- Kim Ko Woon, "A Comparison of Speech Features between Mild Cognitive Impairment and Healthy Aging Groups", Dementia and Neurocognitive Disorders(대한치매학회지), 20(4), pp.52~61 (2021), 대한치매학회[DOI]
- König, A., "Automatic speech analysis for the assessment of patients with predementia and Alzheimer’s disease", Alzheimer’s & Dementia, 29(1) (2015)
- König, A, "Use of speech analyses within a mobile application for the assessment cognitive impairent in elderly people", Current Alzheimer Research, 15 (2018)
- 이승진, "정상 성인에서 음성 및 말소리 범위 프로파일을 이용한 발화 기본주파수 예측", 말소리와 음성과학, 11(3), pp.49~55 (2019), 한국음성학회[DOI]
- 이미숙, "정상 노인과 치매 환자의 단어유창성 특성", Audiology and Speech Research, 15(2), pp.135~143 (2019), 한국청각언어재활학회
- Lezak M. D, "Neuropsychological Assessment" (2012), Oxford University Press
- L. Tóth, "Automatic detection of mild cognitive impairment from spontaneous speech using asr ISCA" (2015)
- Martinez-Nicolás, I., "Ten years of research on automatic voice and speech analysis of people with Alzheimer’s disease and mild cognitive impairment : a systematic review article", Frontiers in Psychology, 12 (2021)
- Martinez-Nicolás, I., "Many changes in speech through aging are actually a consequence of cognitive changes", International Journal of Environmental Research and Public Health, 19 (2022)
- Nagumo, R, "Automatic detection of cognitive impairments through acoustic analysis of speech", Current Alzheimer Research, 17 (2020)
- Oulahaj, Abderrahim, "Predicitng the time of conversion to MCI in the elderly", Neurology, 73(18) (2009)
- Ostrand, Rachel, "Using Automatic Assessment of Speech Production to Predict Current and Future Cognitive Function in Older Adults", Journal of Geriatric Psychiatry and Neurology, 34(5) (2020)
- Parnetti, Lucilla, "Prevalence and risk of progression of prclinical Alzheimer’s disease stages : a systematic review and meta-analysis", Alzheimer’s Research & Therapy, 11(7) (2019)
- Robin, "Using digital speech assessments to detect early signs of cognitive impairment", Frontiers in Digital Health, 3 (2021)
- Risacher L, Shannon, "The role of apolipoprotein E(APOE)genotype in early mild cognitive impairment(E-MCI)", Frontiers in Aging Neuroscience, 5(11) (2013)
- Sutin, R, Angelina, "Verbal Fluency and Risk of Dementia", International Journal of Geriatric Psychiatry, 34(6) (2019)
- Szatloczki, G, "Speaking in Alzheimer’s disease, is that an early sign? Importance of changes in language abilities in Alzheimer’s disease", Frontiers in Aging Neuroscience, 7 (2015)
- Themistocleous, C, "Voice quality and speech fluency distinguish individuals with mild cognitive impairment from healthy control", PLOS ONE (2020)
- Vigo, Ines, "Speech-and language based classification of alzheimer’s disease : A systematic review", Bioengineering, 9(27) (2022)