Predicting Driving Cessation Among Cognitively Normal Older Drivers: The Role of Alzheimer Disease Biomarkers and Clinical Assessments.
Autor: | Babulal GM; From the Department of Neurology (G.M.B., S.A.M., J.C.M.), Division of Biostatistics (L.C.), and Department of Medicine (D.B.C.), Washington University School of Medicine, St. Louis, MO., Chen L; From the Department of Neurology (G.M.B., S.A.M., J.C.M.), Division of Biostatistics (L.C.), and Department of Medicine (D.B.C.), Washington University School of Medicine, St. Louis, MO., Murphy SA; From the Department of Neurology (G.M.B., S.A.M., J.C.M.), Division of Biostatistics (L.C.), and Department of Medicine (D.B.C.), Washington University School of Medicine, St. Louis, MO., Carr DB; From the Department of Neurology (G.M.B., S.A.M., J.C.M.), Division of Biostatistics (L.C.), and Department of Medicine (D.B.C.), Washington University School of Medicine, St. Louis, MO., Morris JC; From the Department of Neurology (G.M.B., S.A.M., J.C.M.), Division of Biostatistics (L.C.), and Department of Medicine (D.B.C.), Washington University School of Medicine, St. Louis, MO. |
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Jazyk: | angličtina |
Zdroj: | Neurology [Neurology] 2024 Jun 25; Vol. 102 (12), pp. e209426. Date of Electronic Publication: 2024 Apr 15. |
DOI: | 10.1212/WNL.0000000000209426 |
Abstrakt: | Background and Objectives: With the aging US population and increasing incidence of Alzheimer disease (AD), understanding factors contributing to driving cessation among older adults is crucial for clinicians. Driving is integral for maintaining independence and functional mobility, but the risk factors for driving cessation, particularly in the context of normal aging and preclinical AD, are not well understood. We studied a well-characterized community cohort to examine factors associated with driving cessation. Methods: This prospective, longitudinal observation study enrolled participants from the Knight Alzheimer Disease Research Center and The DRIVES Project. Participants were enrolled if they were aged 65 years or older, drove weekly, and were cognitively normal (Clinical Dementia Rating [CDR] = 0) at baseline. Participants underwent annual clinical, neurologic, and neuropsychological assessments, including β-amyloid PET imaging and CSF (Aβ Results: Among the 283 participants included in this study, there was a mean follow-up of 5.62 years. Driving cessation (8%) was associated with older age, female sex, progression to symptomatic AD (CDR ≥0.5), and poorer performance on a preclinical Alzheimer cognitive composite (PACC) score. Aβ PET imaging did not independently predict driving cessation, whereas CSF biomarkers, specifically t-Tau/Aβ Discussion: Female sex, CDR progression, and neuropsychological measures of cognitive functioning obtained in the clinic were strongly associated with future driving cessation. The results emphasize the need for early planning and conversations about driving retirement in the context of cognitive decline and the immense value of clinical measures in determining functional outcomes. |
Databáze: | MEDLINE |
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