The collection of speech data for the assessment of cognition remotely: Balancing ethical and practical challenges

Speech biomarkers could form a critical step in improving the accessibility, scalability, and early detection of Alzheimer's disease and related dementias. However, ethical and practical challenges remain across regulatory and cultural contexts. In this paper, we briefly review the challenges in adopting speech biomarkers, relate our experiences globally to recent advances in the neurodegenerative field, and consider how speech assessments could be integrated into clinical care. Insights from high- and low- and middle-income countries (Taiwan, Ghana, Colombia, Brazil, Greece, UK, and US) demonstrate the potential impact of speech technology. While there are common benefits, risks, incentives, and hurdles, many aspects are specific to country or region. There is a need for more speech data sets (particularly in languages other than English), standardization in data collection and analysis, stronger collaboration between machine learning and neurodegenerative disease experts, unified privacy regulation, and finally, a consensus on the clinical interpretation of speech biomarker data.