Driving behavior data may help detect early cognitive decline

Using in-vehicle driving data may be a new way to identify people who are at risk of cognitive decline, according to a study published on November 26, 2025, in Neurology^®, the medical journal of the American Academy of Neurology.

"Early identification of older drivers who are at risk for accidents is a public health priority, but identifying people who are unsafe is challenging and time-consuming," said study author Ganesh M. Babulal, PhD, OTD, of Washington University School of Medicine in St. Louis, Missouri. "We found that using a GPS data tracking device, we could more accurately determine who had developed cognitive issues than looking at just factors such as age, cognitive test scores and whether they had a genetic risk factor related to Alzheimer's disease."

The study involved 56 people with mild cognitive impairment, which is a precursor to Alzheimer's disease, and 242 cognitively healthy people with an average age of 75. All participants were driving at least once a week at the start of the study.

Participants agreed to take tests of thinking skills and to have the data tracking device installed on their vehicles. They were then followed for more than three years.

While the driving patterns of the two groups were similar at the start of the study, over time older adults with mild cognitive impairment had greater reductions in how many times they drove each month, how often they drove at night and how much they varied their routine in where they drove.

The researchers used driving factors such as medium and maximum trip distance, how often people went above the speed limit and how much they varied their routine to predict whether a person had developed mild cognitive impairment with 82% accuracy. Once they added in the factors of age and other demographics, cognitive test scores and whether people had a gene associated with Alzheimer's, the accuracy improved to 87%. In comparison, using all of those factors without any driving information resulted in 76% accuracy.

"Looking at people's daily driving behavior is a relatively low-burden, unobtrusive way to monitor people's cognitive skills and ability to function," Babulal said. "This could help identify drivers who are at risk earlier for early intervention, before they have a crash or near miss, which is often what happens now. Of course, we also need to respect people's autonomy, privacy and informed decision-making and ensure ethical standards are met."

A limitation of the study is that most participants were highly educated, white people, so the results may not be generalizable to the overall population.

The study was supported by the National Institutes of Health and the National Institute on Aging.