In-Vehicle Sensors to Detect Cognitive Change in Older Drivers

项目总结/摘要 与阿尔茨海默病和相关慢性退行性痴呆相关的大脑变化可能 早在临床症状明显之前的20年就开始开始。越来越多的证据表明 对老年人复杂的日常生活活动进行不引人注目的监测， 这些早期认知的微妙变化。传感器的使用不仅在商业领域迅速增加， 汽车、乘用车以及美国道路上的大量老年司机表明，传感器 可以重新配置数据以提供这种预警系统。在这项纵向混合方法研究中，我们 将招募750名老年驾驶员，建立他们的基本认知功能和驾驶行为 配置文件，并每三个月重复一次认知测试和车载传感器数据下载， 年（12个数据点）。在这段时间里，我们预计大约有200名参与者经历了 从未受损至轻度认知障碍水平和/或轻度 认知障碍到早期痴呆水平。我们建议安装一个传感器系统，包括 不显眼的摄像头、车载诊断（OBD）、GPS和惯性测量单元（IMU）， 跟踪并记录这750名老年（≥ 65岁）驾驶员在乘用车中的驾驶员行为。所记录的 驾驶员行为的变化将与来自一组认知测试（全局认知， 执行功能、记忆、视觉空间、视觉注意力和语言），并证明有能力发现 早期认知变化和预测驾驶风险。本研究项目的创新之处在于 测试一个不引人注目的，快速和随时可用的车载传感和监测系统的能力 来检测老年驾驶员认知能力的早期变化。估计有400万到800万老年司机， 轻度认知障碍的道路上在美国这一显着数量的老年司机构成了一个主要的 关注公共安全。此外，大多数人可能不知道发生的认知变化。电流 痴呆症筛查项目只能测试一小部分老年人， 但是，这些早期的、微妙的变化并没有被发现。然而，早期发现提供了许多医疗， 为个人、家庭和社会带来情感和经济利益，为干预打开“时间之窗” 在未来的疾病进展（阿尔茨海默氏症协会2019年报告）。拟议的测试 对一个容易、快速获得的、不显眼的车载传感系统进行评估，可以提供第一个 迈向未来广泛的一步，低成本，早期预警的变化，为大量的老年司机在 美国

Project Summary / Abstract Brain changes associated with Alzheimer's disease and related chronic degenerative dementias may begin as long as 20 years before clinical symptoms become evident. There is increasing evidence that unobtrusive monitoring of older adults' performance of complex daily activities of living may allow us to detect some of these subtle early changes in cognition. The rapidly increasing use of sensors not only in commercial vehicles, but also in passenger vehicles, and large number of older drivers on U.S. roads suggest that sensor data may be reconfigured to provide this early warning system. In this longitudinal mixed methods study, we will recruit and enroll 750 older drivers, establish their baseline cognitive function and driving behavior profiles, and repeat the cognitive testing and in-vehicle sensor data downloading every three months for three years (12 data points). Over this time, we expect approximately 200 participants to have experienced measurable cognitive decline either from unimpaired to mild cognitive impairment levels and/or mild cognitive impairment to early stage dementia levels. We propose to install a sensor system which will include unobtrusive cameras, on-board diagnostics (OBD), GPS and inertial measurement units (IMU) configured to track and record driver behavior in the passenger vehicles of these 750 older adult (≥ 65) drivers. The recorded changes in driver behavior will be compared to results from a battery of cognitive tests (global cognition, executive function, memory, visuospatial, visual attention and language) with demonstrated ability to detect early cognitive changes and to predict driver risk. The innovation of this research project lies in the rigorous testing of an unobtrusive, rapidly and readily available in-vehicle sensing and monitoring system for its ability to detect early changes in cognition in older drivers. There is an estimated 4 to 8 million older drivers with mild cognitive impairment on the roads in the U.S. This significant number of older drivers poses a major concern for public safety. Moreover, the majority may be unaware of the cognitive changes occurring. Current dementia screening programs are able to test only a small number of older adults and the wellness visits covered by Medicare do not detect these early, subtle changes. Yet early detection offers many medical, emotional and financial benefits for the individual, family and society, opening a “window of time” to intervene in the progression of the disease in the future (Alzheimer's Association 2019 Report). The proposed testing and evaluation of a readily and rapidly available, unobtrusive in-vehicle sensing system could provide the first step toward future widespread, low-cost, early warnings of change for the large number of older drivers in the U.S.