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

Early diagnosis 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 large language models (LLMs), to elicit narratives relevant to ADRD from patients and informants. We evaluated the agent with 30 adults with suspected ADRD through conversation analysis, user surveys, and analysis of symptom elicitation compared to blinded specialist interviews. Symptoms detected by the agent showed promising agreement with those identified by specialists. Users appreciated the agent's patience and systematic questioning, which supported engagement and expression of complex, hard-to-describe experiences. While these findings suggest potential for conversational agents as structured diagnostic support tools, further validation with larger samples and assessment of clinical utility is needed before deployment.