Naturalistic Driving Study Investigating Self-Regulation Behavior in Early Alzheimer’s Disease: A Pilot Study

Article type: Research Article

Authors: Paire-Ficout, Laurence^{a; *} | Lafont, Sylviane^b | Conte, Fanny^a | Coquillat, Amandine^b | Fabrigoule, Colette^c | Ankri, Joël^{d; h} | Blanc, Frédéric^e | Gabel, Cécilia^a | Novella, Jean-Luc^g | Morrone, Isabella^{f; g} | Mahmoudi, Rachid^{f; g}

Affiliations: [a] Laboratoire Ergonomie et Sciences Cognitives pour les Transports (LESCOT), IFSTTAR, TS2, France | [b] Unité Mixte de Recherche Épidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE), UMR T_9405, IFSTTAR, TS2, Université de Lyon, Lyon, France | [c] USR 3413 CNRS, Université Bordeaux Segalen, CHU Pellegrin, Bordeaux, France | [d] Center of Gerontology, Public Assistance, Hospitals of Paris, Paris, France | [e] CMRR (Memory Resources and Research Centre), University Hospital of Strasbourg, Strasbourg, France | [f] Department of Geriatrics and Internal Medicine, Reims University Hospitals, Maison Blanche Hospital, Reims, France | [g] Faculty of Medicine, EA C2S 6291 – Cognition, Health, Socialisation, University of Reims Champagne-Ardenne, Reims, France | [h] UMR 1168 INSERM -UVSQ

Correspondence: [*] Correspondence to: Laurence Paire-Ficout, Institut français des sciences et technologies des transports, de l’aménagement et des réseaux (Ifsttar), Transport Santé Sécurité (TS2), Laboratoire Ergonomie et Sciences Cognitives pour les Transports (Lescot), 25, Avenue François Mitterrand, Case 24, 69675 Bron Cedex, France. Tel.: +33 4 72 14 25 32; Fax: +33 4 72 14 68 37; E-mail: laurence.paire-ficout@ifsttar.fr.

Abstract: Background:Because cognitive processes decline in the earliest stages of Alzheimer’s disease (AD), the driving abilities are often affected. The naturalistic driving approach is relevant to study the driving habits and behaviors in normal or critical situations in a familiar environment of participants. Objective:This pilot study analyzed in-car video recordings of naturalistic driving in patients with early-stage AD and in healthy controls, with a special focus on tactical self-regulation behavior. Methods:Twenty patients with early-stage AD (Diagnosis and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV] criteria), and 21 healthy older adults were included in the study. Data collection equipment was installed in their personal vehicles. Two expert psychologists assessed driving performance using a specially designed Naturalistic Driving Assessment Scale (NaDAS), paying particular attention to tactical self-regulation behavior, and they recorded all critical safety events. Results:Poorer driving performance was observed among AD drivers: their tactical self-regulation behavior was of lower quality. AD patients had also twice as many critical events as healthy drivers and three times more “unaware” critical events. Conclusion:This pilot study used a naturalistic approach to accurately show that AD drivers have poorer tactical self-regulation behavior than healthy older drivers. Future deployment of assistance systems in vehicles should specifically target tactical self-regulation components.

Keywords: Alzheimer’s disease, critical events, dementia, naturalistic driving, self-awareness

DOI: 10.3233/JAD-171031

Journal: Journal of Alzheimer's Disease, vol. 63, no. 4, pp. 1499-1508, 2018