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Article

Exploring Handwriting-Based Biomarkers for Alzheimer’s Disease: Identifying Discriminative Features and Tasks to Enhance Diagnostic Accuracy

by
Cansu Akyürek Anacur
1,2,*,
Asuman Günay Yılmaz
3 and
Bekir Dizdaroğlu
4
1
Graduate School of Natural and Applied Sciences, Karadeniz Technical University, 61080 Trabzon, Turkey
2
Department of Computer Engineering, Bitlis Eren University, 13000 Bitlis, Turkey
3
Department of Artificial Intelligence and Data Engineering, Karadeniz Technical University, 61080 Trabzon, Turkey
4
Department of Computer Engineering, Karadeniz Technical University, 61080 Trabzon, Turkey
*
Author to whom correspondence should be addressed.
Diagnostics 2026, 16(5), 697; https://doi.org/10.3390/diagnostics16050697
Submission received: 21 January 2026 / Revised: 13 February 2026 / Accepted: 24 February 2026 / Published: 26 February 2026
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)

Abstract

Background/Objectives: This study proposes a comprehensive classification framework for the automatic detection of Alzheimer’s disease using handwriting data. An enriched feature space is constructed by combining 18 baseline features extracted from raw handwriting signals with 30 additional features derived from established handwriting analysis studies, resulting in a total of 48 features. To enhance clinical practicality, a task reduction analysis is conducted by comparing the full dataset containing 25 handwriting tasks with a reduced dataset comprising 14 selected tasks. Methods: The proposed framework employs a two-stage evaluation strategy involving four feature selection methods (Random Forest Feature Importance, Extreme Gradient Boosting Feature Importance, L1 Regularization and Recursive Feature Elimination), three normalization techniques (Unnormalized, Min–Max and Z-Score), and five baseline machine learning classifiers (Random Forest, Logistic Regression, Multilayer Perceptron, XGBoost and Support Vector Machines). In the second stage, a dynamic ensemble learning strategy is introduced, where the most effective classifiers are adaptively selected for each cross-validation fold and integrated using soft and hard voting schemes. Results: The experimental results demonstrate that reducing the number of tasks leads to an improvement in average classification accuracy from 79.47% to 81.03%, while simultaneously decreasing training time and memory consumption by approximately 40% and 35%, respectively. The highest classification performance, achieving an accuracy of 94.20%, is obtained using the Hard Ensemble combined with L1-based feature selection. Conclusions: These findings highlight that the joint use of enriched feature representations, task reduction, and dynamic ensemble learning provides an effective and computationally efficient solution for handwriting-based Alzheimer’s disease detection.
Keywords: Alzheimer’s detection; ensemble learning; extended feature set; feature engineering; handwriting analysis; task reduction Alzheimer’s detection; ensemble learning; extended feature set; feature engineering; handwriting analysis; task reduction

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MDPI and ACS Style

Akyürek Anacur, C.; Günay Yılmaz, A.; Dizdaroğlu, B. Exploring Handwriting-Based Biomarkers for Alzheimer’s Disease: Identifying Discriminative Features and Tasks to Enhance Diagnostic Accuracy. Diagnostics 2026, 16, 697. https://doi.org/10.3390/diagnostics16050697

AMA Style

Akyürek Anacur C, Günay Yılmaz A, Dizdaroğlu B. Exploring Handwriting-Based Biomarkers for Alzheimer’s Disease: Identifying Discriminative Features and Tasks to Enhance Diagnostic Accuracy. Diagnostics. 2026; 16(5):697. https://doi.org/10.3390/diagnostics16050697

Chicago/Turabian Style

Akyürek Anacur, Cansu, Asuman Günay Yılmaz, and Bekir Dizdaroğlu. 2026. "Exploring Handwriting-Based Biomarkers for Alzheimer’s Disease: Identifying Discriminative Features and Tasks to Enhance Diagnostic Accuracy" Diagnostics 16, no. 5: 697. https://doi.org/10.3390/diagnostics16050697

APA Style

Akyürek Anacur, C., Günay Yılmaz, A., & Dizdaroğlu, B. (2026). Exploring Handwriting-Based Biomarkers for Alzheimer’s Disease: Identifying Discriminative Features and Tasks to Enhance Diagnostic Accuracy. Diagnostics, 16(5), 697. https://doi.org/10.3390/diagnostics16050697

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