Long-term study links daily driving behaviour to early signs of mild cognitive impairment in older adults

A decade-long study has found that subtle changes in everyday driving behaviour may help identify early mild cognitive impairment (MCI) in older adults, offering a real-world digital marker of cognitive decline well before dementia is formally diagnosed.

The research, conducted under the DRIVES Project at Washington University, followed 298 community-dwelling older drivers using GPS-enabled devices installed in their vehicles. Participants, with an average age of 75, were monitored for up to 40 months and underwent annual cognitive testing, Clinical Dementia Rating (CDR) assessments, and APOE ε4 genetic screening.

Driving data reveals early cognitive decline

Out of the total participants, 56 had MCI while 242 had normal cognition (NC). Although both groups were similar at baseline in age, gender, race, and genetic risk, their driving patterns began to diverge over time.

According to the findings:

Older adults with MCI showed a notably steeper decline in the number of monthly trips and nighttime driving.

They also demonstrated reductions in spatial mobility, measured through indicators such as entropy (variability in travel patterns), maximum distance travelled, and radius of movement.

Specific driving features – including medium trip distance, speeding frequency, entropy scores, and maximum travel distance – were effective in distinguishing MCI drivers from cognitively normal drivers, achieving an AUC of 0.82.

When demographic data, APOE ε4 status, and cognitive scores were added, accuracy improved to an AUC of 0.87.

Potential for early detection

Researchers say the findings show that MCI is linked to progressive changes in driving frequency, complexity, and travel range. These behavioural patterns, tracked continuously and unobtrusively, could serve as early digital biomarkers of cognitive decline.