Designing and Evaluating a Conversational Agent for Early Detection of Alzheimer's Disease and Related Dementias

Abstract: Early detection of Alzheimer's disease and related dementias (ADRD) is critical for timely intervention, yet most diagnoses are delayed until advanced stages. While comprehensive patient narratives are essential for accurate diagnosis, prior work has largely focused on screening studies that classify cognitive status from interactions rather than supporting the diagnostic process. We designed voice-interactive conversational agents, leveraging LLMs, to elicit narratives relevant to ADRD from patients and informants. We evaluated the agent with 30 adults with suspected ADRD through conversation analysis (n=30), user surveys (n=19), and clinical validation against blinded specialist interviews (n=24). Symptoms detected by the agent aligned well with those identified by specialists across symptoms. Users appreciated the agent's patience and systematic questioning, which supported engagement and expression of complex, hard-to-describe experiences. This preliminary work suggests conversational agents may serve as structured front-end tools for dementia assessment, highlighting interaction design considerations in sensitive healthcare contexts.