{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T06:02:05Z","timestamp":1780034525165,"version":"3.53.1"},"reference-count":53,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AG067428"],"award-info":[{"award-number":["R01 AG067428"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AG068183"],"award-info":[{"award-number":["R01 AG068183"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AG074302"],"award-info":[{"award-number":["R01 AG074302"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Driving supports independence and quality of life in later life but is vulnerable to age\u2010related and\/or disease\u2010related decline. While cognitive impairment is a well\u2010recognized risk for unsafe mobility, the contribution of sensorimotor function is less understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied 374 cognitively normal older adults (Clinical Dementia Rating\u2009=\u20090 at baseline) enrolled in the DRIVES Project. A SensoryMotor Impairment Index (SMI) was constructed from six domains (grip strength, gait speed, reaction time, hearing, vision, olfaction) and categorized as 0, 1, 2, or \u2265\u20093 impairments. Naturalistic driving was continuously monitored using in\u2010vehicle GPS dataloggers between 2019 and 2025. Linear mixed\u2010effects models tested whether longitudinal driving trajectories differed by baseline SMI, adjusting for age, sex, race, education, body mass index, and cognition (Preclinical Alzheimer's Cognitive Composite).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, participants with higher SMI burden were older and had lower cognitive scores (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Over time, greater sensorymotor impairment was associated with faster declines in driving exposure and spatial range. Compared with SMI\u2009=\u20090, participants with SMI \u2265\u20093 showed steeper reductions in nighttime trips (\u22120.050 vs. \u22120.037 trips\/month), long\u2010distance trips (&gt;\u200920\u2009miles;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and maximum trip distance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), and greater contraction of driving space (entropy and radius of gyration;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Self\u2010reported driving behaviors showed that participants with higher SMI drove fewer days per\u2010week and were more likely to avoid night driving (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Rates of self\u2010reported adverse driving events (e.g., crashes or citations) did not differ significantly across SMI groups, consistent with compensatory self\u2010regulatory behaviors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Greater sensorymotor impairment predicts accelerated decline in naturalistic driving among cognitively normal older adults, independent of cognition. A composite SMI may provide a feasible, low\u2010cost approach to identify older drivers at risk for declining mobility and support timely interventions to prolong safe driving.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70400","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T09:32:51Z","timestamp":1774517571000},"page":"1358-1368","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Naturalistic Driving Outcomes and Sensorimotor Function in Cognitively Normal Older Adults"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6514-0502","authenticated-orcid":false,"given":"Semere","family":"Bekena","sequence":"first","affiliation":[{"name":"Department of Neurology Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9022-2317","authenticated-orcid":false,"given":"Ramkrishna K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimystian","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osvaldo J.","family":"Laurido\u2010Soto","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine in St. Louis  St. Louis Missouri USA"},{"name":"Center for Advancing Health Services, Policy &amp; Economics Research Washington University in St. Louis  Saint Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor","family":"Al\u2010Hammadi","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Dickerson","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy East Carolina University  Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Carr","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine in St. Louis  St. Louis Missouri USA"},{"name":"Department of Medicine Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh M.","family":"Babulal","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine in St. Louis  St. Louis Missouri USA"},{"name":"Department of Psychology University of Johannesburg  Johannesburg South Africa"},{"name":"Department of Neurology and Quantitative Health Science Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010024\u201063663\u2010y"},{"key":"e_1_2_11_3_1","unstructured":"Rural Health Information Hub.\u201cDemographic Changes and Aging Population. In: Rural Aging in Place Toolkit. Rural Health Information Hub \u201d2019 https:\/\/www.ruralhealthinfo.org\/toolkits\/aging\/1\/demographics."},{"key":"e_1_2_11_4_1","volume-title":"Projections of the Size and Composition of the U.S. Population: 2014 to 2060","author":"Colby S. L.","year":"2015"},{"key":"e_1_2_11_5_1","unstructured":"\u201cNational Household Travel Survey \u201daccessed October 9 2025 https:\/\/nhts.ornl.gov\/."},{"key":"e_1_2_11_6_1","volume-title":"Senior Driver Safety & Mobility Background","author":"AAA Public Affairs","year":"2025"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13931"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/25424823251407543"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0167751"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz70856_104724"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40621\u2010017\u20100121\u2010z"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.1076735"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2013.03.022"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gls119"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11357\u2010025\u201002055\u20100"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1037\/0882\u20107974.6.3.403"},{"issue":"11","key":"e_1_2_11_18_1","first-page":"3110","article-title":"Visual Attention Problems as a Predictor of Vehicle Crashes in Older Drivers","volume":"34","author":"Ball K.","year":"1993","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.17\u201021482"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2004.07.008"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209426"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trip.2022.100753"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2006.04.016"},{"key":"e_1_2_11_24_1","volume-title":"Self\u2010Regulation of Driving by Older Adults: A LongROAD Study","author":"Molnar L. J.","year":"2015"},{"key":"e_1_2_11_25_1","volume-title":"The Association of Frailty With Driving Habits Among Older Adults: AAA LongROAD Study","author":"aaafoundation","year":"2019"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2006.00790.x"},{"key":"e_1_2_11_27_1","first-page":"428","volume-title":"Encyclopedia of Clinical Neuropsychology","author":"Goodglass H.","year":"1983"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.38.6.900"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0093567"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awy244"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.11.2412\u2010a"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/26.1.15"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.3758\/s13428\u2010010\u20100024\u20101"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbaf115"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/13872877251378675"},{"key":"e_1_2_11_36_1","unstructured":"\u00a9 2006\u20132016 National Institutes of Health and Northwestern University \u201cNIH Toolbox Scoring and Interpretation Guide for the iPad\u201d."},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13426"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/chemse\/bjab012"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2022.5840"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2024.06.001"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.9608.2"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41597\u2010025\u201005554\u2010z"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/0733464817690679"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2015.12.092"},{"key":"e_1_2_11_45_1","unstructured":"Gait Speed \u201cRehabMeasures Database \u201d(2016) https:\/\/www.sralab.org\/rehabilitation\u2010measures\/gait\u2010speed."},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glu010"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afr113"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.524355"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.2025.050951"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001084"},{"issue":"2","key":"e_1_2_11_51_1","first-page":"95","article-title":"Muscle Weakness in Adults: Evaluation and Differential Diagnosis","volume":"101","author":"Larson S. T.","year":"2020","journal-title":"AFP"},{"key":"e_1_2_11_52_1","unstructured":"AAA Foundation for Traffic Safety \u201cFrailty Physical Function and Driving Status in Older Adults: LongROAD Analysis of the National Health and Aging Trends Study \u201d(2017) https:\/\/aaafoundation.org\/frailty\u2010physical\u2010function\u2010driving\u2010status\u2010older\u2010adults\u2010longroad\u2010analysis\u2010national\u2010health\u2010aging\u2010trends\u2010study\/."},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1177\/07334648221093851"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1177\/0733464820966516"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70400","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.70400","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:18:04Z","timestamp":1780031884000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.70400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":53,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/jgs.70400"],"URL":"https:\/\/doi.org\/10.1111\/jgs.70400","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]},"assertion":[{"value":"2025-10-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}