TY - JOUR
T1 - GPS driving
T2 - a digital biomarker for preclinical Alzheimer disease
AU - Bayat, Sayeh
AU - Babulal, Ganesh M.
AU - Schindler, Suzanne E.
AU - Fagan, Anne M.
AU - Morris, John C.
AU - Mihailidis, Alex
AU - Roe, Catherine M.
N1 - Funding Information:
Dr. Fagan has received research funding from the National Institute on Aging of the National Institutes of Health, Biogen, Centene, Fujirebio, and Roche Diagnostics. She is a member of the scientific advisory boards for Roche Diagnostics, Genentech, and AbbVie and also consults for Diadem, DiamiR, and Otsuka Pharmaceuticals. There are no conflicts.
Funding Information:
Dr. Babulal is supported by the National Institute of Health/National Institute on Aging (grant numbers: AG068183, AG067428, AG056466) and by the BrightFocus Foundation (A2021142S).
Funding Information:
Dr. Morris is funded by NIH grants # P30AG066444, P01AG003991, P01AG026276, U19AG032438, and U19AG024904. Neither Dr. Morris nor his family owns stock or has equity interest (outside of mutual funds or other externally directed accounts) in any pharmaceutical or biotechnology company.
Funding Information:
Dr. Roe is supported by the National Institute of Health/National Institute on Aging (grant numbers: R01AG056466, R01AG068183, R01AG067428) and by the BrightFocus Foundation (A2021142S).
Funding Information:
Dr. Schindler is supported by K23AG053426.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: Alzheimer disease (AD) is the most common cause of dementia. Preclinical AD is the period during which early AD brain changes are present but cognitive symptoms have not yet manifest. The presence of AD brain changes can be ascertained by molecular biomarkers obtained via imaging and lumbar puncture. However, the use of these methods is limited by cost, acceptability, and availability. The preclinical stage of AD may have a subtle functional signature, which can impact complex behaviours such as driving. The objective of the present study was to evaluate the ability of in-vehicle GPS data loggers to distinguish cognitively normal older drivers with preclinical AD from those without preclinical AD using machine learning methods. Methods: We followed naturalistic driving in cognitively normal older drivers for 1 year with a commercial in-vehicle GPS data logger. The cohort included n = 64 individuals with and n = 75 without preclinical AD, as determined by cerebrospinal fluid biomarkers. Four Random Forest (RF) models were trained to detect preclinical AD. RF Gini index was used to identify the strongest predictors of preclinical AD. Results: The F1 score of the RF models for identifying preclinical AD was 0.85 using APOE ε4 status and age only, 0.82 using GPS-based driving indicators only, 0.88 using age and driving indicators, and 0.91 using age, APOE ε4 status, and driving. The area under the receiver operating curve for the final model was 0.96. Conclusion: The findings suggest that GPS driving may serve as an effective and accurate digital biomarker for identifying preclinical AD among older adults.
AB - Background: Alzheimer disease (AD) is the most common cause of dementia. Preclinical AD is the period during which early AD brain changes are present but cognitive symptoms have not yet manifest. The presence of AD brain changes can be ascertained by molecular biomarkers obtained via imaging and lumbar puncture. However, the use of these methods is limited by cost, acceptability, and availability. The preclinical stage of AD may have a subtle functional signature, which can impact complex behaviours such as driving. The objective of the present study was to evaluate the ability of in-vehicle GPS data loggers to distinguish cognitively normal older drivers with preclinical AD from those without preclinical AD using machine learning methods. Methods: We followed naturalistic driving in cognitively normal older drivers for 1 year with a commercial in-vehicle GPS data logger. The cohort included n = 64 individuals with and n = 75 without preclinical AD, as determined by cerebrospinal fluid biomarkers. Four Random Forest (RF) models were trained to detect preclinical AD. RF Gini index was used to identify the strongest predictors of preclinical AD. Results: The F1 score of the RF models for identifying preclinical AD was 0.85 using APOE ε4 status and age only, 0.82 using GPS-based driving indicators only, 0.88 using age and driving indicators, and 0.91 using age, APOE ε4 status, and driving. The area under the receiver operating curve for the final model was 0.96. Conclusion: The findings suggest that GPS driving may serve as an effective and accurate digital biomarker for identifying preclinical AD among older adults.
KW - Global positioning system
KW - Machine learning
KW - Naturalistic driving
KW - Preclinical Alzheimer disease
UR - http://www.scopus.com/inward/record.url?scp=85107985410&partnerID=8YFLogxK
U2 - 10.1186/s13195-021-00852-1
DO - 10.1186/s13195-021-00852-1
M3 - Article
C2 - 34127064
AN - SCOPUS:85107985410
SN - 1758-9193
VL - 13
JO - Alzheimer's Research and Therapy
JF - Alzheimer's Research and Therapy
IS - 1
M1 - 115
ER -