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的不显眼的监测可以使我们 发现一些认知的早期细微变化。传感器的使用迅速增加，不仅 商用车，也包括乘用车，以及美国道路上大量的老年司机 这表明传感器数据可以重新配置以提供这种早期预警系统。在这一纵向 混合方法研究，我们将招募和登记750名老年驾驶员，建立他们的基线认知 功能和驾驶行为配置文件，并重复认知测试和车载传感器数据 每三个月下载一次，持续三年（12个数据点）。在这段时间里，我们预计 大约200名参与者经历了可测量的认知下降， 未受损至轻度认知障碍水平和/或轻度认知障碍至早期阶段 痴呆程度我们建议安装一个传感器系统，包括不显眼的摄像头，在- 车载诊断（OBD）、GPS和惯性测量单元（IMU），配置为跟踪和记录 这750名老年（≥ 65岁）驾驶员在乘用车中的驾驶行为。记录的变化 驾驶员行为将与来自一组认知测试的结果（整体认知， 执行功能、记忆、视觉空间、视觉注意力和语言）， 检测早期认知变化并预测驾驶风险。本课题的创新之处在于 严格测试一个不显眼的，快速和随时可用的车载传感和监测 该系统能够检测老年驾驶员认知的早期变化。估计有4到8个 在美国的道路上，有数百万患有轻度认知障碍的老年司机。 年长司机对公众安全构成重大关切。此外，大多数人可能不知道 发生认知变化。目前的痴呆症筛查项目只能检测一小部分 老年人和医疗保险覆盖的健康访问并没有发现这些早期的微妙变化。 然而，早期发现为个人、家庭和社会提供了许多医疗、情感和经济利益。 社会，打开一个“时间窗口”，以干预疾病的进展，在未来 （Alzheimer’s Association 2019 Report）拟议的测试和评估的一个容易和迅速 可用的、不显眼的车载传感系统可以为未来广泛的、 为美国大量老年驾驶员提供低成本的早期变化预警。

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.