Delta-KNN: Improving Demonstration Selection in In-Context Learning for Alzheimer’s Disease Detection

Chuyuan Li, Raymond Li, Thalia S. Field, Giuseppe Carenini


Abstract
Alzheimer’s Disease (AD) is a progressive neurodegenerative disorder that leads to dementia, and early intervention can greatly benefit from analyzing linguistic abnormalities. In this work, we explore the potential of Large Language Models as health assistants for AD diagnosis from patient-generated text using in-context learning (ICL), where tasks are defined through a few input-output examples. Empirical results reveal that conventional ICL methods, such as similarity-based selection, perform poorly for AD diagnosis, likely due to the inherent complexity of this task. To address this, we introduce Delta-KNN, a novel demonstration selection strategy that enhances ICL performance. Our method leverages a delta score to assess the relative gains of each training example, coupled with a KNN-based retriever that dynamically selects optimal “representatives” for a given input.Experiments on two AD detection datasets across three models demonstrate that Delta-KNN consistently outperforms existing ICL baselines. Notably, when using the Llama-3.1 model, our approach achieves new state-of-the-art results, surpassing even supervised classifiers.
Anthology ID:
2025.acl-long.1253
Volume:
Proceedings of the 63rd Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers)
Month:
July
Year:
2025
Address:
Vienna, Austria
Editors:
Wanxiang Che, Joyce Nabende, Ekaterina Shutova, Mohammad Taher Pilehvar
Venue:
ACL
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Publisher:
Association for Computational Linguistics
Note:
Pages:
25807–25826
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URL:
https://preview.aclanthology.org/landing_page/2025.acl-long.1253/
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Bibkey:
Cite (ACL):
Chuyuan Li, Raymond Li, Thalia S. Field, and Giuseppe Carenini. 2025. Delta-KNN: Improving Demonstration Selection in In-Context Learning for Alzheimer’s Disease Detection. In Proceedings of the 63rd Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers), pages 25807–25826, Vienna, Austria. Association for Computational Linguistics.
Cite (Informal):
Delta-KNN: Improving Demonstration Selection in In-Context Learning for Alzheimer’s Disease Detection (Li et al., ACL 2025)
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PDF:
https://preview.aclanthology.org/landing_page/2025.acl-long.1253.pdf