A Systematic Review and Meta-Analysis of On-Road Simulator and Cognitive Driving Assessment in Alzheimer’s Disease and Mild Cognitive Impairment

Hird, Megan A.; Egeto, Peter; Fischer, Corinne E.; Naglie, Gary; Schweizer, Tom A.

doi:10.3233/jad-160276

Cited by 109 publications

(114 citation statements)

References 72 publications

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“…As there can be medicolegal implications in advising patients about the safety of driving and limited-quality evidence, referring to an official driving evaluation by someone formally trained in making these assessments is an option. Official driving evaluations have been used to evaluate patients with Alzheimer's disease [24]. This option can be considered when multiple factors that affect safe driving are present in a patient.…”

Section: Discussionmentioning

confidence: 99%

When Can I Drive After Orthopaedic Surgery? A Systematic Review

DiSilvestro

Santoro

Tjoumakaris

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures, but the data regarding this topic are diverse and sometimes conflicting. Some studies provide observer-reported outcome measures, such as brake response time or simulators, to estimate when patients can safely resume driving after surgery, and patient survey data describing when patients report a return to driving, but they do not all agree. We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive.

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Section: Discussionmentioning

confidence: 99%

When Can I Drive After Orthopaedic Surgery? A Systematic Review

DiSilvestro

Santoro

Tjoumakaris

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…Another possibility is that the effects of preclinical AD on driving may not occur in everyday driving, but only manifest when an individual is “pushed” or “stressed”, such as driving an unfamiliar vehicle, on unfamiliar roads, while being evaluated under controlled conditions (as in a road test). 37 Future research should test this hypothesis via driving simulators, which can be used to safely vary the level of demandingness of the traffic situation and crash risk. 38 …”

Section: Discussionmentioning

confidence: 99%

Preclinical Alzheimer's disease and longitudinal driving decline

Roe

Babulal

Head

et al. 2016

A&D Transl Res & Clin Interv

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IntroductionLinks between preclinical Alzheimer's disease (AD) and driving difficulty onset would support the use of driving performance as an outcome in primary and secondary prevention trials among older adults (OAs). We examined whether AD biomarkers predicted the onset of driving difficulties among OAs.MethodsOne hundred four OAs (65+ years) with normal cognition took part in biomarker measurements, a road test, clinical and psychometric batteries, and self-reported their driving habits.ResultsHigher values of cerebrospinal fluid (CSF) tau/Aβ42 and phosphorylated tau (ptau181)/Aβ42 ratios, but not uptake on Pittsburgh compound B amyloid imaging (P = .12), predicted time to a rating of marginal or fail on the driving test using Cox proportional hazards models. Hazards ratios (95% confidence interval) were 5.75 (1.70–19.53), P = .005 for CSF tau/Aβ42; 6.19 (1.75–21.88), and P = .005 for CSF ptau181/Aβ42.DiscussionPreclinical AD predicted time to receiving a marginal or fail rating on an on-road driving test. Driving performance shows promise as a functional outcome in AD prevention trials.

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“…Unfortunately, a lack of more specific information about how they diagnosed MCI makes direct comparisons difficult with their study. It may suggest, however, that as MCI progresses, more severe driving errors will come forth (Wheatley et al, 2014; Hird et al, 2016). …”

Section: Discussionmentioning

confidence: 99%

Older Adults with Mild Cognitive Impairments Show Less Driving Errors after a Multiple Sessions Simulator Training Program but Do Not Exhibit Long Term Retention

Teasdale

Simoneau

Hudon

et al. 2016

Front. Hum. Neurosci.

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The driving performance of individuals with mild cognitive impairment (MCI) is suboptimal when compared to healthy older adults. It is expected that the driving will worsen with the progression of the cognitive decline and thus, whether or not these individuals should continue to drive is a matter of debate. The aim of the study was to provide support to the claim that individuals with MCI can benefit from a training program and improve their overall driving performance in a driving simulator. Fifteen older drivers with MCI participated in five training sessions in a simulator (over a 21-day period) and in a 6-month recall session. During training, they received automated auditory feedback on their performance when an error was noted about various maneuvers known to be suboptimal in MCI individuals (for instance, weaving, omitting to indicate a lane change, to verify a blind spot, or to engage in a visual search before crossing an intersection). The number of errors was compiled for eight different maneuvers for all sessions. For the initial five sessions, a gradual and significant decrease in the number of errors was observed, indicating learning and safer driving. The level of performance, however, was not maintained at the 6-month recall session. Nevertheless, the initial learning observed opens up possibilities to undertake more regular interventions to maintain driving skills and safe driving in MCI individuals.

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A Systematic Review and Meta-Analysis of On-Road Simulator and Cognitive Driving Assessment in Alzheimer’s Disease and Mild Cognitive Impairment

Cited by 109 publications

References 72 publications

When Can I Drive After Orthopaedic Surgery? A Systematic Review

When Can I Drive After Orthopaedic Surgery? A Systematic Review

Preclinical Alzheimer's disease and longitudinal driving decline

Older Adults with Mild Cognitive Impairments Show Less Driving Errors after a Multiple Sessions Simulator Training Program but Do Not Exhibit Long Term Retention

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