Sensor-Detected Differences in Behaviors of Older Drivers with Pre-MCI and Mild Cognitive Impairment vs. Unimpaired...

Background: Research to identify changes in driving behavior that occur with the onset of Pre-MCI and MCI is an emerging area with many gaps still to be addressed. These gaps include limited use of objective, continuous measurement of driver behavior in real-life traffic conditions and comprehensive, biomarker-validated, cognitive evaluation based upon both testing and clinical ratings. Using these strategies, the questions addressed in this exploratory study are whether or not differences in driving behavior are indicative of Pre-MCI/MCI and which behaviors are most predictive of Pre-MCI/MCI. Methods: As part of a naturalistic longitudinal study, older drivers with a Montreal Cognitive Assessment score ≥ 19 had telematic sensors installed in their vehicles and underwent comprehensive cognitive assessment quarterly for three years. Thirty-six participants were classified as Unimpaired (n = 23) or Pre-MCI/MCI (n = 10/3) based upon a neuropsychological battery and diagnostic algorithm. A penalized generalized linear mixed-effects model (GLMM) with a logistic link and LASSO regularization was used to model Pre-MCI/MCI group membership vs. unimpaired as a function of ten trip-level telematic features (trip distance, hard acceleration, hard braking, hard turns, speed average, maximum speed, RPM average, fuel level, throttle average, and throttle variability) at the end of their first 12 months in the study. Results: Higher RPM, shorter average trips, and greater throttle variability predicted higher odds of Pre-MCI/MCI, while more frequent hard braking, hard turns, higher mean speed, and lower average throttle (steadier pedal control) predicted lower odds of Pre-MCI/MCI. Conclusions: The model clearly distinguished unimpaired older drivers from those with MCI or Pre-MCI, suggesting that distinct patterns of driver behavior may be related to levels of cognitive function.