A 2.5-year longitudinal assessment of naturalistic driving in preclinical Alzheimer's disease

Catherine M. Roe, Sarah H. Stout, Ganesh Rajasekar, Beau M. Ances, Jessica M. Jones, Denise Head, Tammie L.S. Benzinger, Monique M. Williams, Jennifer Duncan Davis, Brian R. Ott, David K. Warren, Ganesh M. Babulal

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: Emerging evidence shows that cognitively normal older adults with preclinical Alzheimer's disease (AD) make more errors and are more likely to receive a marginal/fail rating on a standardized road test compared to older adults without preclinical AD, but the extent to which preclinical AD impacts everyday driving behavior is unknown. Objective: To examine self-reported and naturalistic longitudinal driving behavior among persons with and without preclinical AD. Method: We prospectively followed cognitively normal drivers (aged 65 + years) with (n = 10) and without preclinical AD (n = 10) for 2.5 years. Preclinical AD was assessed using amyloid positron emission tomography (PET) with Pittsburgh Compound B. The Driving Habits Questionnaire assessed self-reported driving outcomes. Naturalistic driving was captured using a commercial GPS data logger plugged into the on-board diagnostics II port of each participant's vehicle. Data were sampled every 30 seconds and all instances of speeding, hard braking, and sudden acceleration were recorded. Results: Preclinical AD participants went to fewer places/unique destinations, traveled fewer days, and took fewer trips than participants without preclinical AD. The preclinical AD group reported a smaller driving space, greater dependence on other drivers, and more difficulty driving due to vision difficulties. Persons with preclinical AD had fewer trips with any aggression and showed a greater decline across the 2.5-year follow-up period in the number of days driving per month and the number of trips between 1-5 miles. Conclusion: Changes in driving occur even during the preclinical stage of AD.

Original languageEnglish
Pages (from-to)1625-1633
Number of pages9
JournalJournal of Alzheimer's Disease
Issue number4
StatePublished - 2019


  • Alzheimer's disease
  • Automobile driving
  • Biomarkers
  • Motor vehicles


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