NEW YORK (Reuters Health) – Patients in the later stage of preclinical Alzheimer’s disease (AD) are more likely to fail or perform poorly on a test of driving skills, new research suggests.
“Even though people don’t have any problems with thinking, memory or cognition, they are having problems with driving,” Dr. Catherine M. Roe of Washington University School of Medicine in St. Louis, one of the study’s authors, told Reuters Health in a telephone interview.
Drivers with symptomatic AD are more likely to be injured or die in a car crash than older drivers overall, Dr. Roe and her colleagues note in the Journal of Alzheimer’s Disease, online November 20. They previously showed that older adults with no cognitive impairment who had higher levels of AD biomarkers scored worse on measures of driving ability.
To compare preclinical AD stage with driving performance, Dr. Roe and her team looked at 42 cognitively normal adults age 65 or older who had valid driver’s licenses and drove at least once a week. All completed an hour-long, 12-mile driving test. Based on tau and amyloid imaging and cerebrospinal fluid (CSF) testing, 21 were at stage 0 (negative for both biomarkers); 9 at stage 1 (positive for amyloid only); and 12 at stage 2 (positive for amyloid and tau).
Five study participants failed the driving test or received a marginal score, including four who were stage 2 and one who was stage 0. Study participants classified as stage 2 had an odds ratio of 11.4 for receiving a marginal or failing score compared to those at stage 0 or 1 (95% confidence interval, 1.03 to 125.8). However, no differences in neuropsychological test performance were evident between the study participants with failing or marginal scores and those who passed the driving test.
“This suggests that decline in driving performance likely precedes other psychometric measures of objective decline in cognitive performance,” the authors say.
Dr. Roe and her colleagues are now recruiting patients to replicate the study in a larger group, and have also received a grant to study driving in a more naturalistic setting. Study participants have a chip installed under their dashboard, a technology similar to that used in motor vehicle fleet management.
“They let us see how people are driving; they give us data every 30 seconds,” the researcher said. “At the end of the day, what you’re really interested in is how people are driving in daily life.”
Helping older drivers stay on the road safely is becoming increasingly important, she added, noting that by 2050, one in four drivers will be 65 or older.
She recommended that physicians ask older patients about driving at least once a year.
SOURCE: http://bit.ly/2l8Irz5
J Alzheimers Dis 2017.
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