Screening major depressive disorder using vocal acoustic features in the elderly by sex

•Vocal acoustic features are potential biomarkers of elderly depression.•Elderly participants were asked to read a series of mood-inducing sentences.•Variation patterns of acoustic features represented by the correlation distance were learned.•Spectral and energy-related features classified depression in males with AUC of 0.91.•Prosody-related features classified depression in females with AUC of 0.80. Vocal acoustic features are potential biomarkers of elderly depression. Previous automated diagnostic tests for depression have employed unstandardized speech samples, and few studies have considered differences in voice reactivity. We aimed to develop a voice-based screening test for depression measuring vocal acoustic features of elderly Koreans while they read a series of mood-inducing sentences (MIS). In this case-control study, we recruited 61 individuals with major depressive disorder and 143 healthy controls (mean age [SD]: 72 [6]; female, 70%) from the community-dwelling elderly population. Participants were asked to read MIS and their variation pattern of acoustic features represented by the correlation distance between two MIS were analyzed as input features using the univariate feature selection technique and subsequently classified by AdaBoost. Acoustic features showing significant discriminatory performances were spectral and energy-related features for males (sensitivity 0.95, specificity 0.88, and accuracy 0.86) and prosody-related features for females (sensitivity 0.73, specificity 0.86, and accuracy 0.77). The correlation distance between negative and positive MIS was significantly shorter in the depressed group than in the healthy control (F = 18.574, P < 0.001). Small sample size and relatively homogenous clinical profile of depression could limit the generalizability. While reading MIS, spectral and energy-related acoustic features for males and prosody-related features for females are good discriminators for major depressive disorder. These features may be used as biomarkers of depression in the elderly.