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Navigational Decision‐Making Among Older Drivers: An Analysis of Real‐World Driving Patterns
Reihaneh Derafshi, Ganesh Muneshwar Babulal, Sayeh Bayat. Alzheimer s & Dementia, 2023-12-01
Topic: Risk, prevention and care in population studies
Abstract Background Driving is an important aspect of independence for older adults. However, cognitive decline may impair driving abilities and safety. A deeper understanding of the impact of cognitive impairment on driving behaviours in older adults can inform public health strategies to support maintaining their ability to drive safely. This study investigates how older adults with and without cognitive impairment make navigational decisions (e.g., route choice) while driving in real‐world settings. Method Participants were enrolled in longitudinal driving studies at Washington University School of Medicine. GPS dataloggers tracked the daily driving patterns of 246 older drivers (aged 65+), including 230 cognitively normal older adults (CTL; Clinical Dementia Rating [CDR] = 0) and 16 older adults with cognitive impairment (DEM; CDR>0). Spatial clustering and hashing algorithms were employed to analyze each participant’s destinations and route choices. Trips with hard‐braking, sudden‐acceleration, and over‐speeding were considered “adverse behavior.” The Mann‐Whitney U‐test was performed to identify significant differences between the two groups. Result The CTL group had an average age of 68.2 ± 5.7 years and was composed of 46% females, while the DEM group had an average age of 69.2 ± 6.8 years and had 36% females. Additionally, the CTL group had a mean of 16.5 ± 2.3 years of education, while the DEM group had a mean of 16.0 ± 2.3 years of education. The results indicated that drivers with cognitive impairment had fewer full‐cycle trips (i.e., trips with the same start point and destination; p = 0.0165), visited fewer new destinations (p = 0.0210), used fewer distinct routes to reach their most common destination (p = 0.0174), and took fewer distinct routes to reach their most common destination when normalized by the average monthly frequency of this trip (p = 0.0062). No significant differences were observed in the other driving measures. Conclusion This study reveals significant differences in driving patterns between cognitively normal older adults and those with cognitive impairment. Older adults with cognitive impairment exhibited more conservative driving behaviors, such as taking fewer full‐cycle trips and having less variety in their daily driving routes. These findings have important implications for designing interventions to improve mobility for older adults.
Key findings
- Trips with hard‐braking, sudden‐acceleration, and over‐speeding were considered “adverse behavior.” The Mann‐Whitney U‐test was performed to identify significant differences between the two groups.
- Result The CTL group had an average age of 68.2 ± 5.7 years and was composed of 46% females, while the DEM group had an average age of 69.2 ± 6.8 years and had 36% females.
- The results indicated that drivers with cognitive impairment had fewer full‐cycle trips (i.e., trips with the same start point and destination; p = 0.0165), visited fewer new destinations (p = 0.0210), used fewer distinct routes to reach their most common destination (p = 0.0174), and took fewer distinct routes to reach their most common destination when normalized by the average monthly frequency of this trip (p = 0.0062).
- No significant differences were observed in the other driving measures.
- Conclusion This study reveals significant differences in driving patterns between cognitively normal older adults and those with cognitive impairment.
Why it matters
This study used GPS data to compare real-world driving patterns in older adults with and without cognitive impairment, finding that those with impairment made fewer full-cycle trips. It does not test any treatment, cure or prevention, but may inform strategies to support safe driving.
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Study details
- Study designlongitudinal study
- Evidence strengthModerate
How this study scored 44/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 3 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.6 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 2 / 6 | Cited 1.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Sayeh Bayat: h-index 11 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,962 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 2 countries |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 44 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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. Check the citation against the original before you use it.
APA 7th
Derafshi, R., Babulal, G. M., & Bayat, S. (2023). Navigational Decision‐Making Among Older Drivers: An Analysis of Real‐World Driving Patterns. Alzheimer s & Dementia. https://doi.org/10.1002/alz.082435
Vancouver
Derafshi R, Babulal GM, Bayat S. Navigational Decision‐Making Among Older Drivers: An Analysis of Real‐World Driving Patterns. Alzheimer s & Dementia. 2023. doi:10.1002/alz.082435.
BibTeX
@article{derafshi2023-b92c72eb,
author = {Derafshi, Reihaneh and Babulal, Ganesh Muneshwar and Bayat, Sayeh},
title = {{Navigational Decision‐Making Among Older Drivers: An Analysis of Real‐World Driving Patterns}},
journal = {Alzheimer s \& Dementia},
year = {2023},
doi = {10.1002/alz.082435},
url = {https://doi.org/10.1002/alz.082435}
}
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