Predictors of driving safety in early Alzheimer disease

J. D. Dawson, S. W. Anderson, E. Y. Uc, E. Dastrup, Matthew Rizzo

Research output: Contribution to journalArticle

123 Citations (Scopus)

Abstract

OBJECTIVE: To measure the association of cognition, visual perception, and motor function with driving safety in Alzheimer disease (AD). METHODS: Forty drivers with probable early AD (mean Mini-Mental State Examination score 26.5) and 115 elderly drivers without neurologic disease underwent a battery of cognitive, visual, and motor tests, and drove a standardized 35-mile route in urban and rural settings in an instrumented vehicle. A composite cognitive score (COGSTAT) was calculated for each subject based on eight neuropsychological tests. Driving safety errors were noted and classified by a driving expert based on video review. RESULTS: Drivers with AD committed an average of 42.0 safety errors/drive (SD = 12.8), compared to an average of 33.2 (SD = 12.2) for drivers without AD (p < 0.0001); the most common errors were lane violations. Increased age was predictive of errors, with a mean of 2.3 more errors per drive observed for each 5-year age increment. After adjustment for age and gender, COGSTAT was a significant predictor of safety errors in subjects with AD, with a 4.1 increase in safety errors observed for a 1 SD decrease in cognitive function. Significant increases in safety errors were also found in subjects with AD with poorer scores on Benton Visual Retention Test, Complex Figure Test-Copy, Trail Making Subtest-A, and the Functional Reach Test. CONCLUSION: Drivers with Alzheimer disease (AD) exhibit a range of performance on tests of cognition, vision, and motor skills. Since these tests provide additional predictive value of driving performance beyond diagnosis alone, clinicians may use these tests to help predict whether a patient with AD can safely operate a motor vehicle.

Original languageEnglish (US)
Pages (from-to)521-527
Number of pages7
JournalNeurology
Volume72
Issue number6
DOIs
StatePublished - Feb 10 2009
Externally publishedYes

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Alzheimer Disease
Safety
Cognition
Vision Tests
Trail Making Test
Visual Perception
Motor Skills
Neuropsychological Tests
Motor Vehicles
Nervous System Diseases

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Predictors of driving safety in early Alzheimer disease. / Dawson, J. D.; Anderson, S. W.; Uc, E. Y.; Dastrup, E.; Rizzo, Matthew.

In: Neurology, Vol. 72, No. 6, 10.02.2009, p. 521-527.

Research output: Contribution to journalArticle

Dawson, JD, Anderson, SW, Uc, EY, Dastrup, E & Rizzo, M 2009, 'Predictors of driving safety in early Alzheimer disease', Neurology, vol. 72, no. 6, pp. 521-527. https://doi.org/10.1212/01.wnl.0000341931.35870.49
Dawson, J. D. ; Anderson, S. W. ; Uc, E. Y. ; Dastrup, E. ; Rizzo, Matthew. / Predictors of driving safety in early Alzheimer disease. In: Neurology. 2009 ; Vol. 72, No. 6. pp. 521-527.
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