SENSOR
Research type
Research Study
Full title
Symptom and Environmental effects in Neurodegenerative diSease On Real-world driving (SENSOR)
IRAS ID
314729
Contact name
Adam Wagner
Contact email
Sponsor organisation
University of East Anglia
Duration of Study in the UK
2 years, 4 months, 31 days
Research summary
Cognitive decline in ageing and neuropathological disease is a leading factor in changes towards driving behaviour that increase the likelihood of road traffic accidents. Nonetheless, there is a limited understanding as to how and when cognitive changes in Mild Cognitive Impairment and Prodromal Dementia influence driving behaviour. In providing a clinical recommendation over the driving fitness of an individual recently diagnosed with preclinical dementia, current guidance from the DVLA states that a license holder with mild cognitive impairment does not need to inform the licensing agency despite some risk of decline in driving ability; and currently the onus is on the individual themselves and their loved ones to decide when driving should be ceased. However, in cognitive decline, research shows that individuals show reduced self-awareness of their driving safety, and therefore they may continue driving at a greater risk to themselves and other road users. The current study will therefore aim to elucidate how cognitive changes in early dementia influence driving behaviour by measuring driving behaviour and relating this with cognitive markers and biomarkers associated with early dementia. We will measure real-world driving behaviour using GPS location devices fitted to vehicles for two weeks, and relate this to cognitive functioning using state-of-the-art neuropsychological assessments. In addition, we will also be testing for clinical dementia biomarkers using MRI and blood tests, and will collect physical measurements such as height, weight, and blood pressure. Furthermore, we will use location data to assess how environmental factors (i.e. road networks) interact with cognitive markers to explore risk factors towards changed driving behaviour. The newly gained knowledge from this study will lead to an improved understanding as to how driving behaviour is influenced in early dementia, which can inform future disease management recommendations.
Lay summary of study results: The SENSOR study was designed to investigate how cognitive changes associated with Mild Cognitive Impairment (MCI) and dementia influence real-world driving behaviour. Participants completed detailed assessments of memory, thinking, navigation, and health, and had their driving behaviour monitored using GPS devices fitted to their cars. The study also collected information about brain health through blood samples, genetic testing, and MRI scans for some participants. The aim was to understand how changes in cognition may affect driving and whether changes in driving could provide early signs of cognitive decline.
Although the original study aimed to recruit 100 participants, we successfully recruited 90 participants, all of whom completed the study procedures. This represents an excellent achievement and provides one of the most detailed datasets currently available on driving behaviour in older adults with and without cognitive impairment.
Our first analyses have focused on driving speed across different road types and speed limits. The initial findings suggest that people living with MCI or dementia generally drive more slowly than cognitively healthy older adults, particularly on roads with higher speed limits such as 60 mph and 70 mph roads.
Interestingly, the differences were much smaller on slower roads but became more pronounced as speed limits increased. One possible explanation is that driving at higher speeds places greater demands on attention, decision-making, navigation, and the ability to process information quickly. As a result, people experiencing cognitive difficulties may naturally compensate by reducing their speed to feel safer and maintain control of the vehicle.
Importantly, these findings do not suggest that people with MCI or dementia are unsafe drivers. Instead, they indicate that many individuals may adapt their driving behaviour in response to changes in their cognitive abilities. Such adaptations may represent an important strategy that helps people continue driving safely and independently for longer.
These early results are encouraging because they suggest that changes in driving behaviour may provide useful information about brain health. In the future, monitoring driving patterns could potentially help identify cognitive changes earlier and support more personalised approaches to maintaining independence and mobility in older age.
The study has generated a very rich dataset that includes GPS driving information, cognitive assessments, navigation testing, blood biomarkers, genetic information, MRI brain scans, and information about the driving environment. We are currently conducting further analyses to better understand how these factors interact and how they may contribute to changes in driving behaviour over time.
Future analyses will investigate:
• How memory, attention, and navigation abilities relate to real-world driving.
• Whether changes in driving behaviour are associated with biological markers of dementia.
• How different road environments and driving situations influence driving behaviour.
• Whether driving patterns could help identify cognitive decline at an earlier stage.
These findings will be shared through scientific publications, conferences, and future participant updates as the analyses are completed.
Finally, we would like to extend our sincere thanks to all participants, their families, and supporters who gave their time to this research. Their commitment has made this work possible and is helping to advance our understanding of cognitive ageing, dementia, and how we can better support safe mobility and independence in later life.REC name
London - Queen Square Research Ethics Committee
REC reference
22/PR/0928
Date of REC Opinion
22 Sep 2022
REC opinion
Further Information Favourable Opinion