8 ms·

Driving may reveal early signs of Alzheimer's

63 points by bananapear 5y ago

kian 5y ago
Insurance companies will be all over personal data (search, location, and profiles) so that they can statistically discriminate against their clients beyond what they have been thus far able. HIPAA is fairly toothless in many ways, and doesn't even cover cases like this. It's time to start implementing criminal penalties for illegally exfiltrating private health data before it is too late.
- atatatat 5y ago
  Google has the majority of it via legal means..., we need to get a handle on our governments before we even try to protect our digital info...
- hermannj314 5y ago
  Isn't statistical discrimination the basis of fair cohort definition in insurance underwriting? What do you think insurance, as a financial product, is? An entity looking to hedge against financial uncertainty relies on being placed in a cohort that represents equivalent risk profile to their own.
  - plainnoodles 5y ago
    I think insurance is nothing but a serendipitous, temporary alignment of finance, levels of information availability/tracking, and the fundamental right of all humans to life and health. Right now, despite their best efforts, insurance companies are still fairly limited in their ability to discriminate and exclude certain swathes of people from access to affordable healthcare. Once they manage it, they become useless to us as a society. Ideally, we as a society want all of our members to be able to see a doctor when they are sick or injured. Ideally, insurance companies want to exclusively insure people to whom they will never need to pay out. They optimize their profit margin to be essentially 100%. Which then makes them a leech, and they're probably a leech well below 100% as well. (To be fair, since the system is completely inhuman, individuals will also play the same game and try to leave the risk pool if they are sufficiently low-risk.) So, there will come a time when we have to either give up any facade that we value human health intrinsically, or we must stop using private insurance as the primary method of ensuring it (no pun intended).
- bananapear 5y ago
  In the UK it's commonplace for insurers to offer "black box" policies, where a small device including GPS and accelerometers with an mobile internet connection must be fitted to the vehicle in exchange for a discount.
  - carlhjerpe 5y ago
    I wouldn't place one of those in my car if it made the insurance free. I understand why they do it(both parties), but I also think it's disgusting.
fujidust 5y ago
Autopilot-style driver aids can mess with these data points to some extent. Still very interesting that diversity in destination is considered an indicator.
spockz 5y ago
> Specifically, those with preclinical Alzheimer's tended to drive more slowly, make abrupt changes, travel less at night, and logged fewer miles overall, for example. They also visited a smaller variety of destinations when driving, sticking to slightly more confined routes. I wonder what the direction of the causality is. Maybe there is something else that triggers the slow driving. Visiting the same destinations regularly instead of varying ones might also just point to a very routine lifestyle. Maybe that contributes to Alzheimer’s a lot? It feels a stretch to use these attributes as casuals for attribution of Alzheimer’s.
- bachmeier 5y ago
  I think the goal is only to have an early warning of medical issues, rather than finding a causal effect and preventing the issues.
  - mannykannot 5y ago
    Without the measured changes being caused by Alzheimer's, it is unlikely they will have any specificity. On the other hand, the results reported here give at least circumstantial evidence for this causality.
- kortex 5y ago
  There have been some interesting findings in aging studies (e.g. the 90+ study [0]) that suggest some people who have all the physiological signs of Alzheimers, but show no symptoms of dementia. I suspect the arrow goes: X -> brain degradation brain degradation -> cognitive decline cognitive decline -> driving bad brain degradation -> post-mortem Alzheimers diagnosis The loose link there is the path from brain degradation to cognitive decline. The 90+ findings (plus other findings on TBI and plasticity) suggest that by maintaining high plasticity through brain assaults (old age, trauma), it seems the brain can "route around damage" and remain comparatively functional. [0] The 90+ study: https://mind.uci.edu/research-studies/90plus-study/ https://mind.uci.edu/research-studies/90plus-study/ 60 Minutes on Superagers - Video + Transcript: https://www.cbsnews.com/news/long-life-retirement-community-60-minutes-2020-11-22/ https://www.cbsnews.com/news/long-life-retirement-community-...
fortran77 5y ago
Google or Apple, who also know our location, can start targeting Alzheimer ads to people.
- deleted 5y ago
  [deleted]
- amelius 5y ago
  First there must be products that target the disease.
  - Minor49er 5y ago
    Google can simply start marketing residential care ads to the individual as well as their family.
    - ianbooker 5y ago
      I think their AI is already doing that.
  - fortran77 5y ago
    Long term care? Insurance? There doesn't need to be a cure or treatment for companies to make money from it.
rahulnair23 5y ago
From the full paper[1]: > All models were trained on 70% of the data and tested on the remaining 30% of the data. Note that each month record for each participant was considered an independent data point. I'm almost certain that this is a mining leak. Data from one patient will end up both in the training and test set and result in fantastic accuracy. Of course it will be from different months. The correct way to do this is to cross-validate/split across the population. It seems unlikely, from this description, that the authors have done so. [1] https://alzres.biomedcentral.com/articles/10.1186/s13195-021-00852-1#Sec2 https://alzres.biomedcentral.com/articles/10.1186/s13195-021...
- mattkrause 5y ago
  Definitely. It's a very common error and it should be easy to catch but....I've even seen a study that treated individual slices of an MRI as independent, which is laughably wrong. I think part of the problem is that the "analysts" are increasingly uninvolved in the data collection, and just treat it as a tuple of (X, y). If you thought about what they mean, even for a second, ("Oh, Mr. Smith is always an awful driver"), the problem is obvious.
- NwtnsMthd 5y ago
  I'm somewhat unfamiliar with the problem, do you think you could explain why this is bad? Or maybe just point me in the right direction? Thanks!
  - kirykl 5y ago
    Overfits for study participants. Will Not necessarily give same results on gen pop
  - CaptainNegative 5y ago
    Suppose that you have 3 data points, on June 14, 15, and 16, that due to personal driving quirks all appear to belong to the same person. If the 14th and 16th are in your dataset, and both correspond to Alzheimer-free Bob, that may be a strong hint that the data from the 15th is also Alzheimer-free. But this doesn't help you in the real world where you won't necessarily have near neighbors corresponding to the same person, with a known diagnosis.
AnIdiotOnTheNet 5y ago
> Specifically, those with preclinical Alzheimer's tended to drive more slowly, make abrupt changes, travel less at night, and logged fewer miles overall, for example. They also visited a smaller variety of destinations when driving, sticking to slightly more confined routes. Aside from the abrupt changes this could describe my driving habits. I hate driving, driving at night most of all.
- tines 5y ago
  I have some bad news for you buddy
- jsight 5y ago
  I was thinking that these changes weren't described in specific enough detail too. I mean, these could also be used to guess age in general, if I'm reading it right.
- WesolyKubeczek 5y ago
  Yeah, what if I learned to drive late in my life and am simply not confident enough? Or maybe I take speed limits seriously?
- Finnucane 5y ago
  Presumably there is some presumption that everyone in the study has more or less the same driving needs. Possibly for a small area in MO, that might be true, or at least close enough. I mean, I don't drive much either, but I live in a place where I don't have to. I don't need the car to get to work or do most of my ordinary errands. Now, if they want to track my bike, they might get more data.
- xeromal 5y ago
  My take from the article is that the deviation happens over time from your preexisting baseline. So it's not your current habits, its that tracking your habits over time will show a difference.
ben_w 5y ago
I know this is merely an anecdote, but this fits what I saw in my mother. I was learning to drive, visited the parents, we went on a practice drive… and she found speed sufficiently frightening that she asked me to limit myself to 40 MPH, while we were on a 70 MPH dual carriageway A-road. My driving lessons came with a booklet saying doing under 50 on such a road (in normal conditions) would be considered dangerous.
- KineticLensman 5y ago
  > My driving lessons came with a booklet saying doing under 50 on such a road (in normal conditions) would be considered dangerous. Yes! A slow driver (under 50) can cause very high closing speeds for drivers who aren't paying attention. A likely accident scenario could be a driver who tailgates a white van that is itself closing fast on the slow vehicle, blocking the view of the tailgater (all are in the inside lane). If the van makes a late overtaking manoeuvre (to avoid the slow vehicle) rather than smoothly braking, the tailgater has very little time to react, and depending on traffic density, might not themselves be able to change lanes. I saw this exact situation happen a few days ago. I was in lane 2 about 100m further back down the road. The van changed lanes at the last possible moment. The tailgater slammed on his brakes and came very close to shunting the slow vehicle. Luckily there was no-one behind him so a braking wave didn't propagate back down the lane.
  - iso1631 5y ago
    Funny how you'd blame the slow driver rather than the driver not paying attention and/or tailgating. What if the "slow driver" was a normal driver who just got a puncture and was slowing down?
    - ceh123 5y ago
      If the slow driver is fully capable of driving a normal speed and makes the choice to drive well below the speed limit, they are making a choice that directly increases the probability of an accident (regardless of if they are involved in the actual accident or not). If the slow car has an issue that makes it so that they cannot go any faster they should be putting their hazards on and slowing down, in which case it would be the drivers who are not paying attention's fault. Really in both cases the drivers not paying attention share some of the blame, but in the first case the slow driver is also being irresponsible.
nazrulmum10 5y ago
Although this potential scenario is a long way off for the insurance market, it's something that might worry existing owners of black boxes who have already experienced issues with their devices' accuracy in the past.
wirthjason 5y ago
Specifically, those with preclinical Alzheimer's tended to drive more slowly, make abrupt changes, travel less at night, and logged fewer miles overall, for example. They also visited a smaller variety of destinations when driving, sticking to slightly more confined routes. Isn’t this pretty much everyone as they get older? Who hasn’t seem these traits in older relatives? Everyone I know who gets older tends to drive less at night because as you get old your eyesight gets worse —- particularly if you’ve had cataract surgery, which are people who are in the study / risk group. Unless I missed a more nuanced point this article reads like “old age is a good predictor of Alzheimer’s.”
- WhompingWindows 5y ago
  I think the quote ties in with what else we know about Alzheimers: it tends to develop in those with smaller social circles, in those who experience less novelty and less healthy lifestyles. If the person is out in society learning a new language, meeting new people, learning a new instrument, exercising their minds' regenerative capacities, that's a great "counter" to aging. If they're sitting at home, not driving anywhere, watching cable news all day, that's a recipe for rutted-grooves of thought and deterioration of the mind.
  - actually_a_dog 5y ago
    I tend to drive relatively little, visit fairly few distinct places, and generally take the same route each time I visit them. I'm also not a huge fan of night driving. I don't think I drive particularly slowly or make too many abrupt changes (I've never had an accident involving another car, am never the slowest one on the freeway, and have never had a complaint from any of my passengers). The interesting part for me here is that these behaviors do, in fact, reflect a neurological issue I have with visual/spatial processing. In a nutshell, I get lost easily, because it takes me much more time to associate visual landmarks with a travel route than the typical human. I suspect my dog has a far, far better sense of direction than do I. :P I'm not even close to old enough to have preclinical signs of Alzheimer's, yet, but I shall have to remember to remind my doctors of my visual-spatial issues in a few decades when I am.
  - 5y ago

63 points by bananapear 5y ago

kian 5y ago

Insurance companies will be all over personal data (search, location, and profiles) so that they can statistically discriminate against their clients beyond what they have been thus far able. HIPAA is fairly toothless in many ways, and doesn't even cover cases like this. It's time to start implementing criminal penalties for illegally exfiltrating private health data before it is too late.

atatatat 5y ago
Google has the majority of it via legal means..., we need to get a handle on our governments before we even try to protect our digital info...
hermannj314 5y ago
Isn't statistical discrimination the basis of fair cohort definition in insurance underwriting? What do you think insurance, as a financial product, is? An entity looking to hedge against financial uncertainty relies on being placed in a cohort that represents equivalent risk profile to their own.
- plainnoodles 5y ago
  I think insurance is nothing but a serendipitous, temporary alignment of finance, levels of information availability/tracking, and the fundamental right of all humans to life and health. Right now, despite their best efforts, insurance companies are still fairly limited in their ability to discriminate and exclude certain swathes of people from access to affordable healthcare. Once they manage it, they become useless to us as a society. Ideally, we as a society want all of our members to be able to see a doctor when they are sick or injured. Ideally, insurance companies want to exclusively insure people to whom they will never need to pay out. They optimize their profit margin to be essentially 100%. Which then makes them a leech, and they're probably a leech well below 100% as well. (To be fair, since the system is completely inhuman, individuals will also play the same game and try to leave the risk pool if they are sufficiently low-risk.) So, there will come a time when we have to either give up any facade that we value human health intrinsically, or we must stop using private insurance as the primary method of ensuring it (no pun intended).
bananapear 5y ago
In the UK it's commonplace for insurers to offer "black box" policies, where a small device including GPS and accelerometers with an mobile internet connection must be fitted to the vehicle in exchange for a discount.
- carlhjerpe 5y ago
  I wouldn't place one of those in my car if it made the insurance free. I understand why they do it(both parties), but I also think it's disgusting.

fujidust 5y ago

Autopilot-style driver aids can mess with these data points to some extent. Still very interesting that diversity in destination is considered an indicator.

spockz 5y ago

> Specifically, those with preclinical Alzheimer's tended to drive more slowly, make abrupt changes, travel less at night, and logged fewer miles overall, for example. They also visited a smaller variety of destinations when driving, sticking to slightly more confined routes. I wonder what the direction of the causality is. Maybe there is something else that triggers the slow driving. Visiting the same destinations regularly instead of varying ones might also just point to a very routine lifestyle. Maybe that contributes to Alzheimer’s a lot? It feels a stretch to use these attributes as casuals for attribution of Alzheimer’s.

bachmeier 5y ago
I think the goal is only to have an early warning of medical issues, rather than finding a causal effect and preventing the issues.
- mannykannot 5y ago
  Without the measured changes being caused by Alzheimer's, it is unlikely they will have any specificity. On the other hand, the results reported here give at least circumstantial evidence for this causality.
kortex 5y ago
There have been some interesting findings in aging studies (e.g. the 90+ study [0]) that suggest some people who have all the physiological signs of Alzheimers, but show no symptoms of dementia. I suspect the arrow goes: X -> brain degradation brain degradation -> cognitive decline cognitive decline -> driving bad brain degradation -> post-mortem Alzheimers diagnosis The loose link there is the path from brain degradation to cognitive decline. The 90+ findings (plus other findings on TBI and plasticity) suggest that by maintaining high plasticity through brain assaults (old age, trauma), it seems the brain can "route around damage" and remain comparatively functional. [0] The 90+ study: https://mind.uci.edu/research-studies/90plus-study/ https://mind.uci.edu/research-studies/90plus-study/ 60 Minutes on Superagers - Video + Transcript: https://www.cbsnews.com/news/long-life-retirement-community-60-minutes-2020-11-22/ https://www.cbsnews.com/news/long-life-retirement-community-...

fortran77 5y ago

Google or Apple, who also know our location, can start targeting Alzheimer ads to people.

deleted 5y ago
[deleted]
amelius 5y ago
First there must be products that target the disease.
- Minor49er 5y ago
  Google can simply start marketing residential care ads to the individual as well as their family.
  - ianbooker 5y ago
    I think their AI is already doing that.
- fortran77 5y ago
  Long term care? Insurance? There doesn't need to be a cure or treatment for companies to make money from it.

rahulnair23 5y ago

From the full paper[1]: > All models were trained on 70% of the data and tested on the remaining 30% of the data. Note that each month record for each participant was considered an independent data point. I'm almost certain that this is a mining leak. Data from one patient will end up both in the training and test set and result in fantastic accuracy. Of course it will be from different months. The correct way to do this is to cross-validate/split across the population. It seems unlikely, from this description, that the authors have done so. [1] https://alzres.biomedcentral.com/articles/10.1186/s13195-021-00852-1#Sec2 https://alzres.biomedcentral.com/articles/10.1186/s13195-021...

mattkrause 5y ago
Definitely. It's a very common error and it should be easy to catch but....I've even seen a study that treated individual slices of an MRI as independent, which is laughably wrong. I think part of the problem is that the "analysts" are increasingly uninvolved in the data collection, and just treat it as a tuple of (X, y). If you thought about what they mean, even for a second, ("Oh, Mr. Smith is always an awful driver"), the problem is obvious.
NwtnsMthd 5y ago
I'm somewhat unfamiliar with the problem, do you think you could explain why this is bad? Or maybe just point me in the right direction? Thanks!
- kirykl 5y ago
  Overfits for study participants. Will Not necessarily give same results on gen pop
- CaptainNegative 5y ago
  Suppose that you have 3 data points, on June 14, 15, and 16, that due to personal driving quirks all appear to belong to the same person. If the 14th and 16th are in your dataset, and both correspond to Alzheimer-free Bob, that may be a strong hint that the data from the 15th is also Alzheimer-free. But this doesn't help you in the real world where you won't necessarily have near neighbors corresponding to the same person, with a known diagnosis.

AnIdiotOnTheNet 5y ago

tines 5y ago
I have some bad news for you buddy
jsight 5y ago
I was thinking that these changes weren't described in specific enough detail too. I mean, these could also be used to guess age in general, if I'm reading it right.
WesolyKubeczek 5y ago
Yeah, what if I learned to drive late in my life and am simply not confident enough? Or maybe I take speed limits seriously?
Finnucane 5y ago
Presumably there is some presumption that everyone in the study has more or less the same driving needs. Possibly for a small area in MO, that might be true, or at least close enough. I mean, I don't drive much either, but I live in a place where I don't have to. I don't need the car to get to work or do most of my ordinary errands. Now, if they want to track my bike, they might get more data.
xeromal 5y ago
My take from the article is that the deviation happens over time from your preexisting baseline. So it's not your current habits, its that tracking your habits over time will show a difference.

ben_w 5y ago

I know this is merely an anecdote, but this fits what I saw in my mother. I was learning to drive, visited the parents, we went on a practice drive… and she found speed sufficiently frightening that she asked me to limit myself to 40 MPH, while we were on a 70 MPH dual carriageway A-road. My driving lessons came with a booklet saying doing under 50 on such a road (in normal conditions) would be considered dangerous.

KineticLensman 5y ago
> My driving lessons came with a booklet saying doing under 50 on such a road (in normal conditions) would be considered dangerous. Yes! A slow driver (under 50) can cause very high closing speeds for drivers who aren't paying attention. A likely accident scenario could be a driver who tailgates a white van that is itself closing fast on the slow vehicle, blocking the view of the tailgater (all are in the inside lane). If the van makes a late overtaking manoeuvre (to avoid the slow vehicle) rather than smoothly braking, the tailgater has very little time to react, and depending on traffic density, might not themselves be able to change lanes. I saw this exact situation happen a few days ago. I was in lane 2 about 100m further back down the road. The van changed lanes at the last possible moment. The tailgater slammed on his brakes and came very close to shunting the slow vehicle. Luckily there was no-one behind him so a braking wave didn't propagate back down the lane.
- iso1631 5y ago
  Funny how you'd blame the slow driver rather than the driver not paying attention and/or tailgating. What if the "slow driver" was a normal driver who just got a puncture and was slowing down?
  - ceh123 5y ago
    If the slow driver is fully capable of driving a normal speed and makes the choice to drive well below the speed limit, they are making a choice that directly increases the probability of an accident (regardless of if they are involved in the actual accident or not). If the slow car has an issue that makes it so that they cannot go any faster they should be putting their hazards on and slowing down, in which case it would be the drivers who are not paying attention's fault. Really in both cases the drivers not paying attention share some of the blame, but in the first case the slow driver is also being irresponsible.

nazrulmum10 5y ago

Although this potential scenario is a long way off for the insurance market, it's something that might worry existing owners of black boxes who have already experienced issues with their devices' accuracy in the past.

wirthjason 5y ago

Specifically, those with preclinical Alzheimer's tended to drive more slowly, make abrupt changes, travel less at night, and logged fewer miles overall, for example. They also visited a smaller variety of destinations when driving, sticking to slightly more confined routes. Isn’t this pretty much everyone as they get older? Who hasn’t seem these traits in older relatives? Everyone I know who gets older tends to drive less at night because as you get old your eyesight gets worse —- particularly if you’ve had cataract surgery, which are people who are in the study / risk group. Unless I missed a more nuanced point this article reads like “old age is a good predictor of Alzheimer’s.”

WhompingWindows 5y ago
I think the quote ties in with what else we know about Alzheimers: it tends to develop in those with smaller social circles, in those who experience less novelty and less healthy lifestyles. If the person is out in society learning a new language, meeting new people, learning a new instrument, exercising their minds' regenerative capacities, that's a great "counter" to aging. If they're sitting at home, not driving anywhere, watching cable news all day, that's a recipe for rutted-grooves of thought and deterioration of the mind.
- actually_a_dog 5y ago
  I tend to drive relatively little, visit fairly few distinct places, and generally take the same route each time I visit them. I'm also not a huge fan of night driving. I don't think I drive particularly slowly or make too many abrupt changes (I've never had an accident involving another car, am never the slowest one on the freeway, and have never had a complaint from any of my passengers). The interesting part for me here is that these behaviors do, in fact, reflect a neurological issue I have with visual/spatial processing. In a nutshell, I get lost easily, because it takes me much more time to associate visual landmarks with a travel route than the typical human. I suspect my dog has a far, far better sense of direction than do I. :P I'm not even close to old enough to have preclinical signs of Alzheimer's, yet, but I shall have to remember to remind my doctors of my visual-spatial issues in a few decades when I am.
- 5y ago