Your Driving Habits May Reveal Early Signs of Cognitive Decline According to New Neurology Study

Researchers are increasingly looking beyond traditional medical tests to understand how cognitive decline develops in older adults. A new study published on November 26, 2025, in the journal Neurology suggests that something as routine as daily driving behavior may offer valuable clues about early cognitive changes, including mild cognitive impairment (MCI), a known precursor to Alzheimer’s disease.

The research highlights how data collected directly from vehicles—using GPS-based tracking devices—can help identify people at risk of cognitive decline earlier and more accurately than many standard methods currently used in clinical settings.

Why Driving Behavior Matters for Brain Health

Driving is a complex task that depends on multiple cognitive skills working together. These include attention, memory, decision-making, spatial awareness, and reaction time. Even subtle changes in brain function can affect how often, how far, and how confidently someone drives.

The researchers behind this study were interested in whether real-world driving patterns, measured continuously over long periods, could reveal early cognitive changes before serious safety incidents or obvious symptoms occur. This approach is especially important because identifying unsafe drivers early is a major public health priority, yet current screening tools can be time-consuming, intrusive, or limited in accuracy.

Who Took Part in the Study

The study followed 298 older adults with an average age of 75 years. All participants were actively driving at least once a week at the beginning of the study. The group included:

• 56 individuals diagnosed with mild cognitive impairment
• 242 cognitively healthy individuals

Participants agreed to undergo regular thinking and memory tests and to have a GPS data tracking device installed in their vehicles. Researchers then followed them for more than three years, collecting detailed information about their driving habits alongside clinical assessments.

In addition to driving data, the study also accounted for age, demographic factors, cognitive test scores, and whether participants carried a genetic risk factor associated with Alzheimer’s disease, such as the APOE ε4 gene variant.

What the Researchers Tracked in Vehicles

The GPS-based tracking system collected a wide range of driving metrics, including:

• How often participants drove each month
• Whether they drove at night
• The length and distance of trips
• Maximum and medium trip distances
• Speed-related behaviors, including how often drivers exceeded speed limits
• Driving routine variability, measuring how much people changed routes or destinations over time

One particularly interesting metric was how much participants varied their driving routines, sometimes referred to as driving “entropy.” Reduced variability can indicate a tendency to stick to familiar routes, which may reflect declining confidence or cognitive flexibility.

How Driving Patterns Changed Over Time

At the beginning of the study, driving habits between the cognitively healthy group and the group with mild cognitive impairment were largely similar. However, differences became more apparent as time went on.

Older adults with mild cognitive impairment showed:

• A gradual decline in how often they drove
• Significant reductions in night driving
• Less variation in where they drove, sticking more closely to familiar routes

These changes were not sudden but developed progressively, suggesting that driving behavior may serve as an early functional marker of cognitive decline rather than a late-stage warning sign.

How Accurate Were the Predictions?

One of the most striking findings from the study was how well driving data performed as a predictive tool.

• Using driving behavior data alone, researchers were able to predict whether someone had developed mild cognitive impairment with 82% accuracy.
• When they added age, demographics, cognitive test scores, and genetic risk factors, prediction accuracy improved to 87%.
• In comparison, using all those traditional factors without any driving data resulted in only 76% accuracy.

These results suggest that daily driving behavior captures important real-world information that standard clinical measures may miss.

Why This Approach Is So Promising

One major advantage of monitoring driving behavior is that it is low-burden and unobtrusive. Unlike frequent clinic visits or lengthy cognitive tests, GPS tracking works quietly in the background as people go about their normal lives.

This kind of monitoring could allow doctors and families to identify cognitive risks earlier, opening the door for early interventions, lifestyle changes, or closer follow-up—before crashes or near-miss accidents occur, which is often how concerns arise today.

At the same time, the researchers emphasized the importance of respecting autonomy, privacy, and informed consent. Any real-world use of this technology would need to meet strict ethical standards.

Limitations of the Study

While the findings are promising, the researchers were careful to point out some important limitations.

Most participants in the study were highly educated and white, which means the results may not apply equally across more diverse populations. Driving habits can also be influenced by factors such as vision problems, medications, physical limitations, or lifestyle choices, which were not fully explored in this analysis.

Because of these limitations, further studies involving broader and more diverse groups will be needed before this approach can be widely implemented.

The Bigger Picture: Driving and Cognitive Aging

Previous research has already shown that changes in driving behavior often accompany cognitive decline, but many earlier studies relied on short follow-up periods, self-reported data, or small sample sizes. This study stands out because it combines long-term monitoring, objective vehicle data, and clinical cognitive assessments over several years.

Driving is one of the last complex activities many older adults give up, making it a particularly meaningful window into everyday brain function. Subtle shifts—like driving less at night or avoiding unfamiliar routes—may reflect early self-regulation in response to declining cognitive confidence.

What This Could Mean for the Future

If validated in larger and more diverse populations, GPS-based driving analysis could become a valuable tool in aging research, neurology, and public health. It could help clinicians move toward more continuous, real-world monitoring of cognitive health rather than relying solely on occasional clinic-based assessments.

However, any future use must carefully balance safety, privacy, and individual independence, ensuring that technology supports older adults rather than restricting them prematurely.

Research Paper Reference:
Association of Daily Driving Behaviors With Mild Cognitive Impairment in Older Adults Followed Over 10 Years, Neurology (2025).
https://doi.org/10.1212/WNL.0000000000214440