We present DementiaBank-Emotion, the first multi-rater emotion annotation corpus for Alzheimer’s disease (AD) speech. Annotating 1,492 utterances from 108 speakers for Ekman’s six basic emotions and neutral, we find that AD patients express significantly more non-neutral emotions (16.9%) than healthy controls (5.7%; p < .001). Exploratory acoustic analysis suggests a possible dissociation: control speakers showed substantial F0 modulation for sadness (Delta = -3.45 semitones from baseline), whereas AD speakers showed minimal change (Delta = +0.11 semitones; interaction p = .023), though this finding is based on limited samples (sadness: n=5 control, n=15 AD) and requires replication. Within AD speech, loudness differentiates emotion categories, indicating partially preserved emotion-prosody mappings. We release the corpus, annotation guidelines, and calibration workshop materials to support research on emotion recognition in clinical populations.

Simulating dementia patients with large language models (LLMs) is challenging due to the need to jointly model cognitive impairment, emotional dynamics, and nonverbal behaviors over long conversations. We present DemMA, an expert-guided dementia dialogue agent for high-fidelity multi-turn patient simulation. DemMA constructs clinically grounded dementia personas by integrating pathology information, personality traits, and subtype-specific memory-status personas informed by clinical experts. To move beyond text-only simulation, DemMA explicitly models nonverbal behaviors, including motion, facial expressions, and vocal cues. We further introduce a Chain-of-Thought distillation framework that trains a single LLM to jointly generate reasoning traces, patient utterances, and aligned behavioral actions within one forward pass, enabling efficient deployment without multi-agent inference.