Navigational Decision‐Making Among Older Drivers: An Analysis of Real‐World Driving Patterns

Abstract

AbstractBackgroundDriving 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.MethodParticipants 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.ResultThe 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.ConclusionThis 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.