Driver route-following and safety errors in early Alzheimer disease

Uç, Ergun Y.; Rizzo, Matthew; Anderson, Steven W.; Shi, Qixin; Dawson, Jeffrey D.

doi:10.1212/01.wnl.0000139301.01177.35

Cited by 149 publications

(157 citation statements)

References 31 publications

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“…Because normal aging and age-related neurodegenerative conditions such as Alzheimer's disease affect multiple interacting aspects of cognition, we have been evaluating the validity of a composite index reflecting overall cognitive ability for the prediction of driver safety. The findings of this study and others (Rizzo et al, 2001;Uc et al, 2004) provide support for this approach. We anticipate that continued research in this vein will lead to a brief (less than 15 minutes), standardized, inexpensive cognitive screening battery, with automated scoring algorithms and empirically-derived cutoff scores, that will provide a fair and efficacious means of determining driver safety.…”

Section: Figure 2 the Curves According To Cft-recall Scoresupporting

confidence: 79%

“…Difficulties with episodic memory are common in many neurologic conditions, and may dissociate from relatively preserved procedural or motor memory. Such deficits appear to impact most strongly on certain aspects of driving, such as route-following, while preserved procedural memory abilities allow for generally good vehicle control (Anderson et al, 2005;Cavaco et al, 2004;Uc et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Abilities Related to Driving Performance in a Simulator and Crashing on the Road

Anderson

Rizzo

Shi

et al. 2005

Driving Assessment 2005 : Proceedings of the 3rd International Driving Symposium on Human Factors in Driver Assessment, Trainin

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Summary:The purpose of this study was to examine the relationships between performances on standardized neuropsychological measures of cognitive abilities, simulated driving performance, and state crash records in drivers with cognitive decline due to aging and dementia. Participants were 202 experienced older adult drivers ages 55 years and older: 70 had mild dementia due to probable early Alzheimer's disease and 132 had no neurologic disease. All completed a battery of neuropsychological tests and drove contemporaneously on a high fidelity simulator. The participants' State Department of Transportation driving records were monitored for up to two years after testing. The simulator composite score, reflecting overall driving ability, was significantly correlated with overall cognitive ability, as indexed by the neuropsychology composite score, as well as with individual cognitive tests of attention, memory, visuospatial and visuomotor abilities. Drivers who crashed during an intersection incursion scenario performed significantly worse on the composite measure of cognitive function than those who successfully steered around the incurring vehicle. Crashers had specific cognitive deficits on measures of visuomotor abilities and attention. Memory test performances for both verbal information and visual material were associated with subsequent on-road crashes. These findings provide support for the validity of driving simulation as a safe means of evaluating a range of driving responses that cannot be tested on the road, and suggest that relatively simple and inexpensive neuropsychological tests of specific cognitive abilities could be used to help evaluate older drivers' risk of unsafe driving

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Section: Figure 2 the Curves According To Cft-recall Scoresupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Cognitive Abilities Related to Driving Performance in a Simulator and Crashing on the Road

Anderson

Rizzo

Shi

et al. 2005

Driving Assessment 2005 : Proceedings of the 3rd International Driving Symposium on Human Factors in Driver Assessment, Trainin

View full text Add to dashboard Cite

show abstract

“…For instance, a category fluency task was predictive of simulated driving performance in patients with Alzheimer's disease (AD) (Rebok et al, 1994), and the Controlled Oral Word Association Test (COWA) was a predictor of on-road driving performance in patients with early AD (Uc et al, 2004). However, the Word Fluency Test (Duchek et al, 1998;Hunt et al, 1993) for phonemic association and Generative Naming (Whelihan et al, 2005) for semantic association were not related to on-road driving performance in patients with early cognitive decline or AD.…”

Section: Discussionmentioning

confidence: 99%

The Addenbrooke's Cognitive Examination Revised as a potential screening test for elderly drivers

Ferreira

Simões

Marôco

2012

Accident Analysis & Prevention

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a b s t r a c tConsiderable research has shown that neuropsychological tests are predictive of real-world driving ability. The Mini-Mental State Examination (MMSE) is a brief cognitive test that has been commonly used in the assessment of older drivers. However, this test has inherent problems that limit its validity to evaluate cognitive abilities related to driving and to screen for driving impairments in non-demented people. Therefore, it is useful to test new screening instruments that may predict potential unsafe drivers who require an in-depth neuropsychological assessment in a specialised centre. To date, the utility of the Addenbrooke's Cognitive Examination Revised (ACE-R) as an indicator of driving ability has not been established. In the current study, fifty older drivers (mean age = 73.1 years) who were referred for a psychological assessment, the protocol of which included the ACE-R, underwent an on-road driving test. Using linear discriminant analyses, the results highlighted the higher classification accuracy of the ACE-R compared to the MMSE score, particularly for detecting unsafe drivers. Measures of visuospatial and executive functions, which are not incorporated in the MMSE score, had an incremental value in the prediction of driving ability. This emerging brief cognitive test may warrant additional study for use in the fitness to drive assessment of older adults.

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“…We have previously shown that selective deficits of visual motion processing in AD and MCI are associated with disorders of ambulatory and vehicular navigation. 2,9,10 These impairments lead to getting lost and accidental collisions while driving, 11,12 as well as wandering and the loss of independent living. 13,14 We have previously characterized navigational disorders in AD using a standardized real-world test environment, identifying task and subject variables that influence navigational strategies and navigational success.…”

mentioning

confidence: 99%

Detecting navigational deficits in cognitive aging and Alzheimer disease using virtual reality

Cushman¹,

Stein²,

2008

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Driver route-following and safety errors in early Alzheimer disease

Cited by 149 publications

References 31 publications

Cognitive Abilities Related to Driving Performance in a Simulator and Crashing on the Road

Cognitive Abilities Related to Driving Performance in a Simulator and Crashing on the Road

The Addenbrooke's Cognitive Examination Revised as a potential screening test for elderly drivers

Detecting navigational deficits in cognitive aging and Alzheimer disease using virtual reality

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