# Preclinical Alzheimer Disease and Driving

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2020 · $1,069,881

## Abstract

PROJECT SUMMARY/ABSTRACT
 The goal of this research is to characterize the long-term impact of Alzheimer disease (AD) brain
pathology on driving behavior and driving cessation among persons with and without preclinical AD. Our
findings indicate that the long preclinical stage of AD, as reflected in amyloid imaging and cerebrospinal fluid
(CSF) biomarkers among cognitively normal persons, is associated with poorer driving performance on a
standardized road test.
 This research is significant because 36 million licensed drivers are aged 65 years or older, and the
number of older adults in the United States is expected to double by 2050, when 1 in 4 drivers will be 65 years
or older. Motor vehicle crashes are a leading cause of injury and death in older adults. The ability to identify
who will be at most risk of driving decline and to predict when decline will occur will inform early driving safety
intervention trials for older adults. Preclinical AD is an important stage during which to plan and implement
safety measures in anticipation of changes in driving skills with disease progression.
 Our Specific Aims will determine how levels of both novel and well-established AD biomarkers and
other age- and disease-associated factors are related to driving performance across the course of preclinical
AD: (1) To maintain and grow our unique cohort of older adult drivers with and without preclinical AD. (2) To
test whether preclinical AD predicts cross-sectional differences and longitudinal changes in naturalistic driving.
(3) To identify driving, biomarker, clinical, physical, and behavioral predictors of driving cessation, and to
develop predictive models using these variables.
 To test these Specific Aims, we have assembled a multidisciplinary team with expertise in AD,
neuroimaging biomarkers, CSF biomarkers, driving generally, naturalistic driving specifically, cognitive and
brain aging, and longitudinal biostatistical methods. We will capitalize on existing infrastructure to follow our
current cohort of 180 cognitively normal participants with and without preclinical AD, and add additional
participants to create a cohort of 300 individuals. This larger cohort will continue to undergo an annual driving
test, as well as utilize a naturalistic driving methodology that will capture their driving behaviors on an everyday
basis. The long-term impact of AD brain pathology will be defined in several ways to help understand its impact
on driving performance, behavior, and cessation. Additionally, we will create predictive models of driving
cessation.
 Once obtained, this knowledge can be used to create stage-appropriate, personalized, driving-related
safety strategies that can be implemented upon diagnosis, and adjusted throughout disease progression.

## Key facts

- **NIH application ID:** 9953936
- **Project number:** 5R01AG056466-04
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Catherine M Roe
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $1,069,881
- **Award type:** 5
- **Project period:** 2017-08-01 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9953936

## Citation

> US National Institutes of Health, RePORTER application 9953936, Preclinical Alzheimer Disease and Driving (5R01AG056466-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9953936. Licensed CC0.

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