TY - JOUR
T1 - Driving Difficulties Among Patients with Alzheimer's Disease and Other Neurodegenerative Disorders
AU - Fuermaier, Anselm B M
AU - Piersma, Dafne
AU - de Waard, Dick
AU - Davidse, Ragnhild J
AU - de Groot, Jolieke
AU - Doumen, Michelle J A
AU - Bredewoud, Ruud A
AU - Claesen, René
AU - Lemstra, Afina W
AU - Scheltens, Philip
AU - Vermeeren, Annemiek
AU - Ponds, Rudolf
AU - Verhey, Frans
AU - De Deyn, Peter Paul
AU - Brouwer, Wiebo H
AU - Tucha, Oliver
PY - 2019/1/1
Y1 - 2019/1/1
N2 - BACKGROUND/OBJECTIVE: Neurodegenerative disorders impact fitness to drive of older drivers, but on-road driving studies investigating patients with different neurodegenerative disorders are scarce. A variety of driving errors have been reported in patients with Alzheimer's disease (AD), but it is unclear which types of driving errors occur most frequently. Moreover, patients with other neurodegenerative disorders than AD typically present with different symptoms and impairments, therefore different driving errors may be expected.METHODS: Patients with AD (n = 80), patients with other neurodegenerative disorders with cognitive decline (i.e., vascular dementia, frontotemporal dementia, dementia with Lewy bodies/Parkinson's disease, n = 59), and healthy older drivers (n = 45) participated in a fitness-to-drive assessment study including on-road driving.RESULTS: Patients with AD performed significantly worse than healthy older drivers on operational, tactical, visual, and global aspects of on-road driving. In patients with AD, on-road measures were significantly associated with 'off-road' measures. Patients with neurodegenerative disorders other than AD showed large overlap in the types of driving errors. Several driving errors were identified that appear to be characteristic for patients with particular neurodegenerative disorders.CONCLUSION: Patients from each group of neurodegenerative disorders commonly display tactical driving errors regarding lane positioning, slow driving, observation of the blind spot, and scanning behavior. Several other tactical and operational driving errors, including not communicating with cyclists and unsteady steering, were more frequently observed in patients with non-AD neurodegenerative disorders. These findings have implications for on-road and 'off-road' fitness-to-drive assessments for patients with neurodegenerative disorders with cognitive decline.
AB - BACKGROUND/OBJECTIVE: Neurodegenerative disorders impact fitness to drive of older drivers, but on-road driving studies investigating patients with different neurodegenerative disorders are scarce. A variety of driving errors have been reported in patients with Alzheimer's disease (AD), but it is unclear which types of driving errors occur most frequently. Moreover, patients with other neurodegenerative disorders than AD typically present with different symptoms and impairments, therefore different driving errors may be expected.METHODS: Patients with AD (n = 80), patients with other neurodegenerative disorders with cognitive decline (i.e., vascular dementia, frontotemporal dementia, dementia with Lewy bodies/Parkinson's disease, n = 59), and healthy older drivers (n = 45) participated in a fitness-to-drive assessment study including on-road driving.RESULTS: Patients with AD performed significantly worse than healthy older drivers on operational, tactical, visual, and global aspects of on-road driving. In patients with AD, on-road measures were significantly associated with 'off-road' measures. Patients with neurodegenerative disorders other than AD showed large overlap in the types of driving errors. Several driving errors were identified that appear to be characteristic for patients with particular neurodegenerative disorders.CONCLUSION: Patients from each group of neurodegenerative disorders commonly display tactical driving errors regarding lane positioning, slow driving, observation of the blind spot, and scanning behavior. Several other tactical and operational driving errors, including not communicating with cyclists and unsteady steering, were more frequently observed in patients with non-AD neurodegenerative disorders. These findings have implications for on-road and 'off-road' fitness-to-drive assessments for patients with neurodegenerative disorders with cognitive decline.
KW - Alzheimer's disease
KW - Automobile driving
KW - Cognitive decline
KW - Dementia with Lewy bodies
KW - Frontotemporal dementia
KW - Neurodegenerative diseases
KW - Parkinson's disease
KW - Vascular dementia
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85067550187&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31045516
U2 - https://doi.org/10.3233/JAD-181095
DO - https://doi.org/10.3233/JAD-181095
M3 - Article
C2 - 31045516
SN - 1387-2877
VL - 69
SP - 1019
EP - 1030
JO - Journal of Alzheimer s disease
JF - Journal of Alzheimer s disease
IS - 4
ER -