[HN Gopher] Seeking early signals of dementia in driving and cre...
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       Seeking early signals of dementia in driving and credit scores
        
       Author : tysone
       Score  : 65 points
       Date   : 2021-08-26 18:13 UTC (4 hours ago)
        
 (HTM) web link (www.nytimes.com)
 (TXT) w3m dump (www.nytimes.com)
        
       | [deleted]
        
       | neonate wrote:
       | https://archive.is/x5U1H
        
       | vmception wrote:
       | Regarding the credit scores study, this may not have to do with
       | _forgetting_ payments as a precursor to dementia, it may have to
       | do with costly medical issues that was the precursor to dementia
       | which caused the financial stress
        
       | Ozzie_osman wrote:
       | I'm curious if driving in particular could predict other things,
       | like ADHD / bipolar. Having had a few friends on the spectrum, it
       | definitely felt like their driving patterns were quite different
       | than other people on the road.
        
         | N1H1L wrote:
         | I am curious. There may very well be patterns. Like that recent
         | article where an algorithm could guess the ethnicity of
         | patients from X-rays, such patterns may very well be present in
         | driving
        
         | huge87 wrote:
         | What did you observe in your friends' driving patterns that was
         | different? I'm very curious.
        
       | SV_BubbleTime wrote:
       | I had a commanding officer in the military who was showing signs
       | of dementia.
       | 
       | He was making... let's say, very bad tactical decisions. In the
       | game way past his prime. But this was a whole different level.
       | 
       | We were going to let his family know but it turns out it was
       | becoming obvious in other areas. He was doing weird things like
       | leaving doors open, eating a lot of sweets, and being paranoid
       | about washing his hands all the time.
       | 
       | Not a good scenario, really crazy condition. Sad for the people
       | that got left to deal with him.
        
       | giantg2 wrote:
       | This other article about writing style risks is interesting. If
       | it's accurate, then I will probably have early onset alzheimer's.
       | I miss articles, misspell, and repeat words. I'm only in my
       | 30s...
       | 
       | https://www.nytimes.com/2021/02/01/health/alzheimers-predict...
        
       | ImaCake wrote:
       | A word of caution about machine learning models in academia. The
       | advertised predictive ability or AUC is often inflated, sometimes
       | by a lot. I am not sure why, but I imagine it comes down to the
       | usual p-hacking incentives. Maybe it is because you only need to
       | apply your model to more than one "independent" dataset before
       | you publish a paper. Or simply that academics in diverse fields
       | often lack the nuanced knowledge to realise their model is
       | predicting based on some experimental artifact in their data.
       | 
       | Digital phenotyping has a lot of promise. But considering the
       | unusually conservative old boys club that seems to dominate
       | alzheimers research I would be particularly suspicious of any
       | research on the disease.
        
         | timy2shoes wrote:
         | Fantastic point. Another thing about academic ml models is that
         | they're commonly evaluated on in-sample data. For example,
         | medical AI devices are commonly evaluated on data coming from
         | the same source/hospital that the training data comes from (see
         | https://www-cdn.law.stanford.edu/wp-
         | content/uploads/2021/04/...). This leads to over-confidence in
         | the performance because of overfitting of batch effects.
        
       | jacobkg wrote:
       | My grandmother had very serious dementia. I remember a year or so
       | before we were aware of it that she almost ran a cyclist off the
       | road which was very uncharacteristic.
        
         | Baeocystin wrote:
         | One of the early signs that foreshadowed my mother's decline
         | was the deterioration of her driving skills, and this preceded
         | almost all other noticeable symptoms.
         | 
         | Driving is a complex skill that requires rapid, continuous
         | sensory integration to perform well. It makes sense to me that
         | it is something that would first show a deficit.
        
         | ben_w wrote:
         | One of the early signs in both my mother's and grandmother's
         | Alzheimer's was forgetting to pay (UK) road tax. Somehow both
         | of them managed to get away with being on the road for the next
         | six months, before the rest of the family found out and
         | intervened.
         | 
         | At least in my mother's case, this was far from the only thing
         | that suddenly became wrong with her driving; she also developed
         | a fear of going over about 50 mph and using gears above third,
         | and one sign we only recognised in retrospect was that she
         | forgot how maps worked.
        
       | bryanrasmussen wrote:
       | >Regarding the credit scores study, this may not have to do with
       | forgetting payments as a precursor to dementia,
       | 
       | or my ADHD regularly costing me late fees. I'm ok with it until
       | some company turns out to be just as disorganized as me, because
       | they never have to pay for their foibles.
        
         | echelon wrote:
         | > ADHD regularly costing me late fees
         | 
         | The world is set up against us.
         | 
         | That, and the fact that the world revolves around _morning
         | people_. I 'm still writing code at 3 AM, and you want me to be
         | up for a 10:00 meeting?
         | 
         | I'm lucky to be in a career where I can avoid this stuff, but
         | it doesn't fix the rest of the rigidly broken world.
        
           | steve_adams_86 wrote:
           | One thing I've found profoundly useful is not thinking of the
           | world as set up against me, but more so that I'm my own worst
           | enemy. I'm set up against myself.
           | 
           | Nothing external will change, so there's no sense fretting
           | about my environment naturally suiting my psychology, because
           | that'll never happen. That's a fantasy. I'd code til 3am too
           | (and have, far too many times) but I've come to believe my
           | job in the present is all about setting up future me for
           | success. Present me tends to have shitty ideas about what to
           | do in the present, but plenty of great ideas about what I
           | should have done in the past or should do in the future.
           | Without being critical of present me, I'm likely to fuck
           | things up properly. I need to focus on the scaffolding for
           | those great ideas for future me and less on the shitty ones
           | for present me. That guy is already a lost cause.
           | 
           | My strategy is one of delayed gratification, which my brain
           | hates. I lay down with a book at 9 or 10pm because it'll put
           | me to sleep in a hurry even though my brain is typically
           | WIRED when I lay down. Yeah it doesn't feel like bed time,
           | but it sure as shit is bed time. I'll do other things like
           | keep shitty food out of my home, because otherwise I'll find
           | really good reasons to eat (too much) of it. I put EVERYTHING
           | in my calendar because although present me is positive future
           | me will remember, that's totally incorrect and I actually do
           | need frequent reminders of pretty much everything I'm not
           | immediately focused on or interested in. I leave my phone
           | behind because even though I'm sure I won't use it too much,
           | yeah, I definitely will. Expect the worst from yourself and
           | prepare accordingly.
           | 
           | So, the world isn't my problem, I am! I'm my worst enemy. The
           | path to defeating myself is doing a lot of stuff I don't feel
           | like doing. I like this approach because rather than being
           | mad at the world for my failures, I'm forced to do something
           | about it.
           | 
           | That's my experience, anyway.
        
             | echelon wrote:
             | > I'm set up against myself.
             | 
             | You're not the problem. The world is.
             | 
             | Don't blame yourself.
        
             | salt-thrower wrote:
             | > Nothing external will change
             | 
             | Decades of activism disagree. One example: people in
             | wheelchairs used to be called "invalids" and pretty much
             | couldn't get anywhere in public. Then the ADA was signed,
             | and public spaces are much more accessible as a result.
             | 
             | A healthy balance between stoic acceptance and dutiful
             | activism is the optimal approach, I think.
        
               | quantumBerry wrote:
               | >One example: people in wheelchairs used to be called
               | "invalids" and pretty much couldn't get anywhere in
               | public.
               | 
               | I suppose all the photographs of President Franklin
               | Roosevelt traveling all across the world, entering the
               | governor's office and ultimately the whitehouse were
               | fakes since these all happened before the ADA.
               | 
               | The fact one of our very active presidents was confined
               | to a wheelchair really puts a hole in your ADA theory of
               | invalids.
        
               | bcassedy wrote:
               | Is your counterpoint really that FDR was able to go
               | places in public?
               | 
               | He notoriously hid his disability with a combination of
               | canes, braces, and family members to hold him upright and
               | even simulate walking.
               | 
               | He also had a tremendous amount of power and money to
               | force or provide his own special accommodations. Like
               | having an army of secret service agents to help him deal
               | with stairs.
        
               | quantumBerry wrote:
               | I quote you as follows: people in wheelchairs "pretty
               | much couldn't get anywhere in public."
               | 
               | I assert that you are quite wrong, and I provide you an
               | example of it happening. We shouldn't discount his
               | achievements.
        
               | bcassedy wrote:
               | "People pretty much couldn't go to space" "Well actually
               | Richard Branson went to space. That puts a big hole in
               | your people pretty much couldn't go to space argument now
               | doesn't it!?"
               | 
               | The example of a single person with nearly endless
               | resources accomplishing something does nothing to refute
               | a point about the masses. Heck, the "pretty much"
               | qualifier is an acknowledgement that some people got
               | around despite their condition.
               | 
               | I assert that you are not discussing this in good faith
               | and won't be engaging with you further.
        
               | quantumBerry wrote:
               | Wow, pretty much anything can be refuted when you operate
               | entirely against a wondrous straw man. I didn't say a
               | word about space. It would be pretty dumb to say people
               | couldn't pretty much go to space.
               | 
               | You've made abundantly clear that your "good faith"
               | worries about others are in fact a projection of your own
               | problem with keeping the good faith.
        
           | [deleted]
        
           | elliekelly wrote:
           | You mean like the ADHD obstacle course we have to complete in
           | order to get medication? It's maddening.
        
           | bspammer wrote:
           | When I was a teenager I was really hoping that when I grew up
           | I would stop being sleepy in the morning and then becoming
           | wide awake around 11pm.
           | 
           | Hasn't changed at all. Everyone's got some way that society
           | doesn't work for them though. Being left handed, too short,
           | too tall, a minority, wheelchair-bound etc. All things
           | considered I have it pretty good.
        
             | steve_adams_86 wrote:
             | Yeah, 100% - my dull brain has somehow managed to give me a
             | relatively comfortable life. Plenty of problems crop up but
             | I've got food, a family, a job. I used to resent this brain
             | quite a bit but I've come to like it a lot. It could have
             | been worse.
        
         | hunter2_ wrote:
         | As someone with no relevant diagnosis but who considers their
         | memory and attention to be occasionally questionable, I find a
         | solution (not always attainable, but I try) in mustering up the
         | energy to create [recurring, if applicable] calendar entries
         | with reminders. Anything to streamline and reduce the friction
         | associated with doing so, such as using voice assistants as
         | much as possible, is super helpful. The slightest bit of
         | thought along the lines of "I'll probably remember" to get out
         | of documenting the reminder is a major catalyst for failure.
         | 
         | Therefore, I'd consider the quantity/frequency of such
         | reminders (detectable by cloud calendar/reminder providers) to
         | be an early indicator of such issues.
        
           | Spooky23 wrote:
           | My wife and I have a paper calendar and we have a meeting
           | every Wednesday where we check in and record bills and make
           | payments. We get 15-20 bills a month for reasons.
           | 
           | We also moved all bills back to paper, as it's easier to
           | track that than various email based accounts.
        
             | syntheticnature wrote:
             | I've long used paper with tracking as one of the reasons,
             | but due to the pandemic's effects one actually wound up a
             | month late (and other attempts to keep track also missed
             | it).
        
         | fshbbdssbbgdd wrote:
         | I have ADHD and I don't think I have a single bill that is not
         | on autopay. The only exception was the property tax on my
         | house, until the time I made the expensive mistake of
         | forgetting to pay it. Then I refinanced my house and had them
         | pay the property tax out of escrow. I'm pretty sure I could
         | fall off the face of the earth and none of my creditors would
         | notice until my job stopped paying me and my checking account
         | ran dry.
        
       | JoeAltmaier wrote:
       | I was part of a project to measure reaction times in a primitive
       | driving simulator. Accelerator, brake, steering wheel from a
       | gaming setup. You drove down a straight road, some roadside
       | scenery went by. Every so often you went through a gate. The gate
       | would sometimes close just as you got there. Measured whether you
       | hit the brake in time. Simple, a little challenging. The idea
       | was, for drivers to self-measure if they were still able to drive
       | safely. Tried to pitch it to an insurance company that rhymes
       | with Slate Charm.
       | 
       | They acted like it was poison. They didn't want to even appear to
       | be trying to select out older customers. The legal trouble they'd
       | have, discriminating according to age (or even appearing to try)
       | would have brought a landslide down on them.
        
         | gowld wrote:
         | How long ago was this?
         | 
         | Now, insurance companies put trackers in cars and adjust rates
         | based on actual speeding and braking.
        
         | paulryanrogers wrote:
         | Could be a market for BMVs since they're responsible for
         | license renewal. And they already test eye sight.
        
         | MontyCarloHall wrote:
         | Huh, if they can legally justify explicitly discriminating
         | based on sex and age (younger men generally pay more than
         | younger women, while older women generally pay more than older
         | men) I'm surprised they couldn't figure out a way to
         | discriminate based on age alone.
         | 
         | Edit: here [0] is a breakdown of car insurance costs,
         | stratified by age/sex. Young people pay by far the most, with
         | premiums steadily declining until age 50 and then rising again.
         | So I'm not sure what their objection might have been, since
         | they already do charge old people more (presumably at a level
         | accurately reflecting their relative risk).
         | 
         | [0] https://www.valuepenguin.com/how-age-affects-auto-
         | insurance-...
        
           | maxerickson wrote:
           | Of course they discriminate on age. They don't want to make
           | it clear to the people they are doing it too.
        
             | MontyCarloHall wrote:
             | > They don't want to make it clear to the people
             | 
             | Wouldn't a driving sim be the exact opposite of that?
             | 
             | "To make our premiums accurately reflect _your_ driving
             | habits and avoid lumping you into crude demographics like
             | the other insurers, we offer all our customers an
             | opportunity to take a spin in our driving sim and get a
             | truly personalized rate reflecting your excellent driving
             | habits."
        
           | scottlamb wrote:
           | Worse: couldn't figure out a way to "discriminate" based on a
           | bona fide measure of driving ability that (I imagine) only
           | loosely correlates with age.
           | 
           | But age discrimination laws/enforcement are seemingly one-
           | way, and the elderly vote and sue, so...
        
           | bpodgursky wrote:
           | In the US, it is legal (in a hiring context) to discriminate
           | against young people, but not against old people. For better
           | or for worse, it's not parallel.
        
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