Project AMM26

Driver Effect of Cognitive Impairment and Spatial Orientation and Navigation (DECISION)

How everyday car driving can change as we age


Prior to a dementia diagnosis, people are often concerned about the possibility of giving up driving, and the loss of independence this entails. However, a better understanding of which pre-diagnosis symptoms predict driving ability will enable people to drive safer for longer.

We used a combination of established questionnaires and psychology tasks, combined with innovative new assessments, to create driver-specific profiles.

Our research question was: which profiles predict different driving styles?

Project Aims

  • established thinking and driving profiles in older drivers.
  • investigated which environmental factors and dementia-related symptoms could lead to unsafe driving.
  • established a driving safety calculator based on individuals’ thinking and driving profiles.

Project Activity

The study comprised two phases: a UK-wide online study which collected self-reports of driving, followed by a smaller in-person study which collected in-car sensor data.

The online phase recruited over 1,000 participants.

  • The study was completed online, via our website (
  • We asked participants to complete some questionnaires about their background, general health, and driving experience.
  • We also asked participants to complete some thinking tasks that assess their memory, attention, and navigation ability.
  • These questionnaires and tasks took no more than 90 minutes to complete.

The in-person phase was put on-hold due to COVID restrictions.

Anticipated outputs

Dr. Morris (Co-I) sits on the Secretary of State for Transport’s Honorary Medical Advisory Panel on Driving and Psychiatric Disorders, and so fed the study findings into the panel to help medical professionals deal with driving licence issues in older adults.

For NHS staff, a diagnosis of dementia requires them to provide medical information to the DVLA, who then make a decision as to the patient’s fitness to drive. This is time-consuming for NHS staff, and is difficult for patients who may feel that their freedoms have been compromised.

We hope that our findings provided NHS staff with an important set of tools with which to collect relevant information in a time-efficient manner. Patients will also be reassured that their road safety is being assessed fairly.

Papers/resources associated with this study

Next steps

  • analyse the UK-wide data to investigate how cognitive profiles predict driving styles.
  • launch the in-person phase of the study. This second phase will combine more detailed cognitive assessments, in-car sensor data, and genetic samples, to calculate individual driver risk of accident.

Research Team

Principle Investigator

Professor Michael Hornberger, University of East Anglia :

Researchers and institutions

Dr. Mary Fisher-Morris, Private chartered psychologist (Co-I)

Dr. Stephen Jeffs, University of East Anglia (Researcher)