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58/100

✓ Peer-reviewed alzhub usefulness score 58 out of 100. Getting a diagnosis

Topic: Risk, prevention and care in population studies

Background and objectives Driving integrates multiple cognitive, sensory, and motor systems and may serve as a real-world indicator of functional decline in aging. Older adults with mild cognitive impairment (MCI) often experience subtle driving changes before formal dementia diagnosis, but longitudinal, real-world evidence is limited. This study examined whether naturalistic driving data can differentiate older adults with MCI from those with normal cognition (NC) over time and evaluated the discriminative ability of driving features compared with conventional risk factors. Methods We conducted a prospective, observational cohort study of community-dwelling older drivers enrolled in the Driving Real-World In-Vehicle Evaluation System Project at Washington University. Participants underwent annual Clinical Dementia Rating assessment, neuropsychological testing, and apolipoprotein ε4 (APOE ε4) genotyping. Driving behaviors were captured daily for up to 40 months using global positioning system-enabled in-vehicle dataloggers, recording trip frequency, duration, distance, time of day, speeding, hard braking, and spatial mobility (entropy, maximum distance, radius of gyration). Longitudinal changes were analyzed using linear mixed-effect models, adjusting for age, sex, race, education, and APOE ε4. Logistic regression with reciever operator curve analysis evaluated discrimination between older adults with MCI and those with NC, compared with conventional sociodemographic and genetic markers. Results Among 298 participants (MCI, n = 56; NC, n = 242; mean age 75.1 years; 45.6% female), the groups were similar in age, sex, race, and APOE ε4 status at baseline, as well as in most driving behaviors. Over time, drivers with MCI showed greater reductions in monthly trip count (MCI: -0.501, standard error [SE]: 0.21, 95% CI [-0.923 to -0.083] vs NC: -0.523, SE: 0.09, 95% CI [-0.709 to -0.337]; p p p Discussion MCI was associated with progressive declines in driving frequency, complexity, and spatial range, supporting naturalistic driving data as a potential unobtrusive digital biomarker for early cognitive decline. Limitations of the study include a predominantly White, highly educated sample and a lack of external validation, warranting cautious interpretation. Continuous monitoring could augment clinical assessments, inform driving safety decisions, and guide interventions to preserve mobility in aging.

Key findings

This study examined whether naturalistic driving data can differentiate older adults with MCI from those with normal cognition (NC) over time and evaluated the discriminative ability of driving features compared with conventional risk factors.
Logistic regression with reciever operator curve analysis evaluated discrimination between older adults with MCI and those with NC, compared with conventional sociodemographic and genetic markers.
Results Among 298 participants (MCI, n = 56; NC, n = 242; mean age 75.1 years; 45.6% female), the groups were similar in age, sex, race, and APOE ε4 status at baseline, as well as in most driving behaviors.
Over time, drivers with MCI showed greater reductions in monthly trip count (MCI: -0.501, standard error [SE]: 0.21, 95% CI [-0.923 to -0.083] vs NC: -0.523, SE: 0.09, 95% CI [-0.709 to -0.337]; p < 0.001), nightly trips (MCI:-0.334, SE: 0.17, 95% CI [-0.675 to 0.001] vs NC:-0.339, SE: 0.07, 95% CI [-0.480 to -0.197]; p < 0.001), and random entropy (MCI:-0.008, SE: 0.004, 95% CI [-0.016 to -0.001]; NC:-0.014, SE: 0.002, 95% CI [-0.017 to -0.011]; p < 0.001).

Why it matters

This study tracked daily driving in older adults to see whether driving patterns could tell apart those with mild cognitive impairment from those with normal cognition. It is about spotting early decline, not about treating, curing, or preventing Alzheimer's disease.

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Study details

Study designcohort
Participants298
Effect sizeAUC 0.82 (95% CI 0.75-0.89) for driving features distinguishing MCI from normal cognition
Evidence strengthEarly

Limitations

Predominantly white, highly educated volunteers at a single site; no external validation; MCI group small (n=56); driving data cannot yet be used clinically.

How this study scored 58/100

Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it. We have no data on free to read, so that was left out: it earned 57 of the 98 points we could judge it on, which is 58 out of 100.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (Neurology)
Journal's citation record	4 / 4	Neurology: journal h-index 525 (OpenAlex, 2026-10-29)
Study design	7 / 12	A cohort study following people over time
Strength of evidence	2 / 5	Rated “early” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	4 / 5	2025 — within 3 year(s) of the newest study here
Sample size	2 / 4	298 participants
Effect reported	3 / 3	Effect reported with a statistic (interval, p-value, ratio or similar)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	1 / 7	Cited 4 times (OpenAlex, 2026-10-10)
Citations per year	1 / 5	1.3 citations a year over 3 year(s) since 2025
Impact for its field and year	4 / 6	Cited 8.8× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	1 / 4	Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Ganesh Muneshwar Babulal: h-index 31 (OpenAlex, whole career)
Institution's track record	2 / 3	Washington University in St. Louis: institution h-index 1,962 (OpenAlex)
Multi-centre collaboration	0 / 3	OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete)
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 41296993)
Free to read	— / 2	Access not recorded — left out of this score
Points	57 / 98	Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 57 of the 98 points we could judge it on is 58 out of 100.
Total	58 / 100	—

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Read the original

Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.

APA 7th

Chen, L., Carr, D. B., Singh, R. K., Bekena, S., Zhu, Y., Taylor, K., et al. (2025). Association of Daily Driving Behaviors With Mild Cognitive Impairment in Older Adults Followed Over 10 Years. Neurology. https://doi.org/10.1212/WNL.0000000000214440

Vancouver

Chen L, Carr DB, Singh RK, Bekena S, Zhu Y, Taylor K, et al. Association of Daily Driving Behaviors With Mild Cognitive Impairment in Older Adults Followed Over 10 Years. Neurology. 2025. doi:10.1212/WNL.0000000000214440. PMID: 41296993.

BibTeX

@article{chen2025-41296993,
  author  = {Chen, L. and Carr, D. B. and Singh, R. K. and Bekena, S. and Zhu, Y. and Taylor, K. and Trani, J. F. and Babulal, G. M.},
  title   = {{Association of Daily Driving Behaviors With Mild Cognitive Impairment in Older Adults Followed Over 10 Years}},
  journal = {Neurology},
  year    = {2025},
  doi     = {10.1212/WNL.0000000000214440},
  pmid    = {41296993},
  url     = {https://doi.org/10.1212/WNL.0000000000214440}
}

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