# Cognitive Function and Older Drivers with MCI: In-Vehicle Instrumentation inthe APPS Study

> **NIH NIH RF1** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2021 · $1,113,750

## Abstract

Project Summary
Mild cognitive impairment (MCI) is often viewed as a transitional state leading to Alzheimer's disease. Drivers
with MCI have decreased driving performance as well as steeper declines in driving exposure and driving
difficulty. While driving is clearly contraindicated as dementia advances, it is critical to examine to what extent safe
driving skills can be maintained in MCI. This is because driving cessation is linked to incident depression, reduced
physical activity and healthcare access, and greater risk for long term care placement and mortality. Policies and
procedures for detecting at-risk older drivers are either non-existent or remain controversial due to a lack of an
evidence-basis. Interventions to aid in maintaining driving fitness are lacking. The Applying Programs to Preserve
Skills Study (APPS) was previously funded by NIH (R01AG045154) with data collection complete as of October
2019. APPS is a single-masked randomized clinical trial to evaluate processing speed training on on-road driving
skills in persons with MCI as evaluated by a certified driving rehabilitation specialist (CDRS) and backseat
evaluator. The vehicle for driving performance was instrumented with a data acquisition system which recorded
vehicle kinematics and 5-channel video of the roadway environment and driver. The impact of the APPS visual
processing speed training intervention on objectively measured driving performance and behaviors was not an aim
in the APPS R01, nor was the collection and analysis of this objective driving data included in the APPS budget.
We collected this data in anticipation of applying for funding to specifically analyze these complex, valuable data
after the APPS study was complete. Vehicle instrumentation to measure objective on-road and behind the wheel
events is a major methodological step forward in understanding declining cognitive abilities and driving. Our
research plan has the following aims. Aim 1: To examine cross-sectional and longitudinal associations between
cognitive function in older drivers with MCI and on-road driving performance (e.g., speed maintenance, steer
steadiness, lane control, turning). Aim 2: To examine the impact of a visual processing speed training intervention
on driving performance and behaviors (as described in Aim 1) based on vehicle kinematics and driver behaviors
among older drivers with MCI. Aim 3: To examine the association between driving performance in older drivers
with MCI (as described in Aim 1) and driving performance ratings by a CDRS, currently the clinical gold standard.
All aims will consider the roles of potentially confounding factors. This research will identify potentially aberrant
driving maneuvers associated with cognitive impairment in MCI, contributing to the eventual development of a
clinical tool to identify older drivers at high-risk for unsafe driving.

## Key facts

- **NIH application ID:** 10232761
- **Project number:** 1RF1AG072773-01
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** GERALD MCGWIN
- **Activity code:** RF1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $1,113,750
- **Award type:** 1
- **Project period:** 2021-05-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10232761

## Citation

> US National Institutes of Health, RePORTER application 10232761, Cognitive Function and Older Drivers with MCI: In-Vehicle Instrumentation inthe APPS Study (1RF1AG072773-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10232761. Licensed CC0.

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