Naturalistic driving behavior among older adults with and without epilepsy: A pilot study.

Objectives: Insufficient data exist for driving risk for people with epilepsy (PWE). This longitudinal, retrospective case-control study examines the differences in driving behaviors among older adults with/without epilepsy history using a novel naturalistic driving datalogger.

Methodology: Eligible participants were cognitively normal ([CDR] = 0) or had mild cognitive impairment (MCI) ([CDR] = 0.5), age ≥ 65, self-reported epilepsy history, and had a global positioning system datalogger installed in their vehicle, which collected data every 30 s during driving trips. Driving data captured between January 2023 and January 2025, aggregated monthly, were included. Linear mixed-effects (LME) models assessed longitudinal driving behavior data as a function of epilepsy status using a matched (age, sex, and education) case-control design.

Results: In this pilot study, epilepsy history had a significant effect on the y-intercept/baseline in models for driving parameters related to driving distance and speed. Longitudinal differences in LME models were shown for driving parameters associated with in-vehicle time, driving distance, and speed. PWE drove slower, less frequently (e.g., fewer trips), and spent more non-driving time in vehicles.

Conclusion: Important differences in driving behaviors may exist between drivers with and without epilepsy. New, effective methods to unobtrusively measure longitudinal driving behavior of PWE are feasible and can improve clinical management at the patient level. More studies are needed to elucidate the relationship between specific driving behaviors and driving risk in PWE.