AbstractBackgroundCognitive decline is a leading early predictor of dementia risk and may be evident in real‐world (RW) digital data even before patients ever present to clinic. This study examined the feasibility of using video and digital sensor profiles of real world (RW) driving in adverse weather as a marker of dementia risk.Method70 older drivers (mean age = 75.6 years) without dementia participated in a RW driving study for 2, 3‐month periods, one year apart (Wang, et al. 2021) . Self‐reported demographics and neuropsychological tests relevant to dementia and driving were collected at study start. Drivers were classed as cognitively neurotypical (N = 33) or impaired (N = 44) based on normed neuropsychological scores. Sensors installed in each driver’s vehicle collected video, speed, and GPS data across 405,104 miles driven. GIS data categorized roadway type (residential, commercial, interstate). A computer vision model (99% accuracy) we developed classed roads as clear or poor (rain, snow). Bayesian mixed‐effect logistic regressions assessed driver speed limit compliance (vehicle speed‐posted speed limit) across driver class, roadway, and weather.ResultDrivers were 8.01 times more likely to speed on interstates (95% CI: 7.61‐8.61) than residential roads (15‐25 mph). Impaired drivers were 15% more likely to drive slower than neurotypical drivers on clear roadways (95% C: 1.0413‐1.2829). This pattern reversed in poor weather with impaired drivers driving faster than neurotypical (b = 0.74, 95% CI: 0.57‐0.94)ConclusionDigital biomarkers from RW data show promise to screen for early dementia risk, advancing research and innovative clinical trials to prevent dementia. Driving challenges, like poor weather, discriminate cognitive decline before dementia. Impaired drivers showed self‐restriction by driving slower on clear roads and reduced self‐restriction by driving faster in poor weather despite risk. Big data strategies, like computer vision, complement driver performance data to identify RW environmental risk, paving the road for the car as a medical diagnostic device.
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