Longitudinal associations between plasma biomarkers and changes in naturalistic driving behaviors in older adults

BackgroundThe aging United States population is expected to significantly increase by 2050, along with Alzheimer's disease (AD), a leading cause of cognitive impairment among older adults. AD is associated with declines in driving abilities and compromised safety, yet early detection remains challenging. Plasma biomarkers like ptau₂₁₇ and Aβ_42/40 are potential tools for detecting preclinical AD, offering a less invasive and scalable alternative to traditional methods.ObjectiveThis study explored the relationship between plasma biomarkers (ptau₂₁₇ and Aβ_42/40) and longitudinal changes in naturalistic driving behaviors in older adults.MethodsParticipants were enrolled in longitudinal studies occurring in The DRIVES Project, which included older adults aged 65 and above who were cognitively normal at baseline. Longitudinal driving behaviors were captured daily using GPS-based data loggers, while plasma biomarkers were used to examine preclinical AD. Linear mixed-effects models assessed the relationship between preclinical AD and driving behaviors over a four-year period.ResultsParticipants with preclinical AD based on ptau₂₁₇ exhibited a decline in driving behaviors, including fewer long trips and visits to unique destinations, while driving more frequently per month. Preclinical AD based on Aβ_42/40 showed increased shorter trips and reduced entropy. Both plasma analytes were associated with longitudinal changes in driving behaviors, but no significant differences in adverse events were observed.ConclusionsPlasma analytes ptau₂₁₇ and Aβ_42/40, are associated with subtle changes in driving behaviors, offering a non-invasive tool for early detection of preclinical AD. Driving behaviors analysis could be integrated into clinical practice for earlier intervention and better management of AD progression.