This profile is part of a series focused on Brown faculty members and students engaged in science and research, with the purpose of highlighting and making more accessible the work being pursued at all levels across disciplines.
Professor of Neurology Brian Ott will soon begin conducting research on the effect of mild cognitive impairment and early Alzheimer’s dementia on driving ability by using a car video-monitoring device.
Previous research has shown that most individuals at an early stage of cognitive impairment can drive safely without getting into accidents for several years, and that two-thirds of those impacted can pass road tests. But many people still believe in banning cognitively impaired people from driving at all, Ott said.
“We don’t want to terminate someone’s driving prematurely because it’s so important in terms of their livelihood, social life and independence,” Ott said. “So we need to pay attention not just for safety reasons, but also to help these people remain autonomous if we can.”
Funded by the National Alzheimer’s Association and centered at the Alzheimer’s Disease and Memory Disorders Center at Rhode Island Hospital, Ott’s research will examine whether a monitoring device called DriveCam can improve driving ability by providing video feedback. When a two-way camera in the car senses risky driving, it records for 12 seconds and transmits the clip to a central site wirelessly, where the video events are collected and posted on a website for the driver to review later.
“So if the driver steps on the brakes too hard or the car jiggles precariously, the camera will capture what the driver was seeing, hearing and doing before and after the incident,” Ott said.
Previously, DriveCam has been used successfully with teenage drivers to reduce unsafe driving. Ott said he hopes people with Alzheimer’s and mild cognitive impairment will equally benefit from the video footage.
“Spouses or other caregivers can coach someone with Alzheimer’s by going over the videos with them and reviewing unsafe driving events — what’s causing them and what could be done to avoid them in the future,” Ott said.
In a pilot study funded by the department of neurology, Ott’s research team examined how 12 people with mild dementia responded to the DriveCam, finding that it reduced the severity of unsafe driving events by 60 percent over a period of three months. The current study, which will take place in a few months, will include a more controlled trial of a larger group of people.
“If we can show that it’s effective, it can improve the safety of our roads. It’s a good safety check as well as a training device,” he said. Ott has been involved in research related to driving and cognitive impairment for the last 15 years. Besides his DriveCam study, he has also studied the natural course of driving decrement and how it relates to cognitive impairment.
His research found that people affected by mild dementia were able to continue driving safely for around one year, while those with very mild cognitive impairment were able to continue driving for double that time, as measured by a general road test.
But another study at Washington University in Saint Louis found that some research participants without any cognitive impairment also declined in their ability to perform in the road test over time, Ott said.
Responding to this finding, Ott said some of these test subjects may be “developing Alzheimer’s changes in their brains.”
In another of Ott’s studies, he is investigating this possibility. In the study, he conducts amyloid PET scans on participants who are cognitively normal in order to see if the presence of amyloid plaque is associated with unsafe driving behavior. Beta amyloid is a protein fragment, and in Alzheimer’s disease, these fragments accumulate to form plaques between neurons in the brain, according to the Alzheimer’s Association website.
Besides his focus on driving, Ott also engages in research on experimental therapeutic treatment and prevention methods for Alzheimer’s. One of the major trials involves monthly anti-amyloid antibody injections that may reduce amyloid plaque burden in people without any cognitive impairment, Ott said. But these people are already recognized as being at-risk due to evidence of amyloid plaque in their brains from PET scans, he added.
“These plaques may build up in the brain 10 or 20 years before you even have symptoms,” Ott said. “So if the trial is successful, it could be a major game-changer in how we treat the disease.”
