A 2.5-Year Longitudinal Assessment of Naturalistic Driving in Preclinical Alzheimer’s Disease

Article type: Research Article

Authors: Roe, Catherine M.^{a; b; *} | Stout, Sarah H.^{a; b} | Rajasekar, Ganesh^{a; b} | Ances, Beau M.^{a; b; c} | Jones, Jessica M.ⁱ | Head, Denise^{a; d} | Benzinger, Tammie L.S.^{a; b; c; d; e} | Williams, Monique M.^f | Davis, Jennifer Duncan^g | Ott, Brian R.^g | Warren, David K.^h | Babulal, Ganesh M.^{a; b}

Affiliations: [a] Charles F. and Joanne Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, MO, USA | [b] Department of Neurology, Washington University School of Medicine, MO, USA | [c] Department of Hope Center for Neurological Disorders, Washington University School of Medicine, MO, USA | [d] Department of Radiology, Washington University School of Medicine, MO, USA | [e] Department of Neurosurgery, Washington University School of Medicine, MO, USA | [f] Department of BJC Medical Group, Washington University School of Medicine, MO, USA | [g] Department of Brown University, School of Medicine, MO, USA | [h] Department of Medicine, Washington University School of Medicine, MO, USA | [i] Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA

Correspondence: [*] Correspondence to: Catherine M. Roe, PhD, 660 S. Euclid Ave., Campus Box 8111, St. Louis, MO, USA. Tel.: +1 314 747 1474; E-mail: cathyr@wustl.edu.

Abstract: Background:Emerging evidence shows that cognitively normal older adults with preclinical Alzheimer’s disease (AD) make more errors and are more likely to receive a marginal/fail rating on a standardized road test compared to older adults without preclinical AD, but the extent to which preclinical AD impacts everyday driving behavior is unknown. Objective:To examine self-reported and naturalistic longitudinal driving behavior among persons with and without preclinical AD. Method:We prospectively followed cognitively normal drivers (aged 65 + years) with (n = 10) and without preclinical AD (n = 10) for 2.5 years. Preclinical AD was assessed using amyloid positron emission tomography (PET) with Pittsburgh Compound B. The Driving Habits Questionnaire assessed self-reported driving outcomes. Naturalistic driving was captured using a commercial GPS data logger plugged into the on-board diagnostics II port of each participant’s vehicle. Data were sampled every 30 seconds and all instances of speeding, hard braking, and sudden acceleration were recorded. Results:Preclinical AD participants went to fewer places/unique destinations, traveled fewer days, and took fewer trips than participants without preclinical AD. The preclinical AD group reported a smaller driving space, greater dependence on other drivers, and more difficulty driving due to vision difficulties. Persons with preclinical AD had fewer trips with any aggression and showed a greater decline across the 2.5-year follow-up period in the number of days driving per month and the number of trips between 1–5 miles. Conclusion:Changes in driving occur even during the preclinical stage of AD.

Keywords: Alzheimer’s disease,, automobile driving,, biomarkers, motor vehicles

DOI: 10.3233/JAD-181242

Journal: Journal of Alzheimer's Disease, vol. 68, no. 4, pp. 1625-1633, 2019