INDICATE: Introduction of an Online Cognitive Battery for Fitness to Drive in Mild Cognitive Impairment and Dementia

Testing an online cognitive tool that turns research into a practical way to assess driving fitness in people with Mild Cognitive Impairment (MCI) and early dementia across the UK to improve national driving assessment practices and guidelines.

Why is the research needed?

Cognitive changes are a defining feature of dementia and Mild Cognitive Impairment (MCI). While memory problems are well known, other difficulties, such as spatial disorientation, are also common and can affect a person’s ability to drive safely. Despite the importance of this issue, there is currently very limited understanding of how specific cognitive changes relate to fitness to drive and to future road traffic incident risk in people with MCI or dementia. 

The project looked to rectify this shortcoming by building on our previous DECISION study. DECISION established a normative cognitive data set in over 1,000 older, healthy drivers, which can be now used as a benchmark for people with Mild Cognitive Impairment and dementia.  

What are we doing?

Our project introduces an online cognitive test battery specifically designed to assess fitness to drive in people with Mild Cognitive Impairment (MCI) and early dementia. We have now partnered with Driving Mobility, who will use our tests as part of their cognitive assessment for individuals with MCI or dementia across their 17 centres across the UK.

We aim to test whether online assessments are feasible in this population, evaluate their reliability and validity against existing assessments, and identify which specific cognitive deficits are linked to unsafe driving and incident risk.

To test this effectively, participants will complete standard (“gold‑standard”) cognitive assessments and on‑road driving evaluations, take part in the study by completing online cognitive tests and questionnaires, and be followed up after 12 months to determine whether cognitive changes predict future driving risk.

How are we working with communities, services and organisations?

The project is delivered in partnership with GP surgeries and dementia memory clinics. Through this collaboration, recruitment takes place directly within real‑world clinical and assessment services, participants are individuals who have undergone driving‑fitness evaluations, and the research is embedded within routine assessment pathways, ensuring strong relevance to real‑world practice.

What will the impact and benefits of this research be?

The anticipated benefits include a better understanding of how cognitive impairment affects driving safety, stronger evidence to support decision‑making about fitness to drive in people with MCI and dementia, and potential improvements to national assessment practices and guidelines. Together, these outcomes may help shape future driving‑assessment practice and policy.

What do we have planned for knowledge mobilisation and implementation?

Our findings are expected to inform future driving assessment practice and guidelines by improving clinical, regulatory and assessment guidance for driving in MCI and dementia.

Related papers, outputs and resources

Read the related paper from the DECISION study, titled 'The Impact of Spatial Orientation Changes on Driving Behaviour in Healthy Aging'

Read the related paper from the DECISION study, titled 'Feasibility and reliability of online vs in-person cognitive testing in healthy older people'

Read the related paper from the DECISION study, titled 'GPS navigation assistance is associated with driving mobility in older drivers'

Who is involved?

  • Lead Researcher: Professor Michael Hornberger, University of Southampton (formerly University of East Anglia UEA)
  • Dr Mary Fisher‑Morris, Transport’s Honorary Medical Advisory Panel
  • Dr Sol Morrissey, University of East Anglia (UEA)
  • Miss Rachel Gillings, University of East Anglia (UEA)

Get in contact

Email Michael Hornberger at m.hornberger@soton.ac.uk. 

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