Investigating the autonomic nervous system and cognitive functions as potential mediators of an association between cardiovascular disease and driving performance

Abstract

Cardiovascular disease (CVD) impacts the autonomic nervous system and cognitive functions related to activities of daily living, including driving an automobile. Although CVD has been linked to unsafe driving, mechanisms underlying this relationship remain elusive. The aim of this study was to examine the role of cognitive functions and the autonomic nervous system as potential mediators of driving performance. Nineteen individuals having recently suffered a cardiac event and sixteen individuals with no history of CVD completed a simulated drive using a STISIM simulator to assess driving performance. Heart rate was recorded throughout testing using a Polar RS800CX heart rate monitor and measures of executive, orienting and alerting functions were obtained through the Attention Network Test. We used the Baron and Kenny analysis method to assess potential mediating effects of the relationship between CVD and driving performance. Executive function was the only potential mediator investigated to be associated with driving (p < 0.01) and CVD (p < 0.05), however, it did not appear to play a mediating role (p = 0.28). These results suggest that individuals with CVD exhibit decrements in complex cognitive tasks such as driving and that further research is needed to better understand the mechanisms underlying this relationship.

Preliminary observations on MRI correlates of driving independence and performance in persons with heart failure

“…Specifically, Alosco and colleagues in 2013 demonstrated Brain volume, WMH and driving 425 that greater impairments on a cognitive composite comprised of measures assessing multitasking, working memory, basic and complex attention, and inhibition predicted greater centerline crossings and increased% of time spent out of the lane [4]. Recent work also demonstrates impaired simulated driving in a heterogenous sample of persons with cardiac disease that was suggested to in part stem from high rates of deficits in driving-related cognitive abilities (e.g., executive dysfunction) [7]. These findings in HF, and cardiovascular disease more broadly, are consistent with the extant evidence that shows the adverse effect of cognitive dysfunction on safe driving in other patient populations (e.g., Alzheimer's disease; Parkinson's disease) [8,9].…”

“…Cognitive function did not emerge as a mediator between cardiovascular health and driving performance in a past study among cardiac patients, suggesting that the mechanisms for impaired driving in cardiovascular disease remain unclear and deserves further study [7]. Although not previously examined, the adverse effects of structural and ischemic brain injury on cognitive function in HF patients [10,11] may underlie poor driving ability in this population.…”

Effects of an aerobic exercise program on driving performance in adults with cardiovascular disease

“…This was done during a simulated drive using the Manitoba Road Test form, a standardized demerit-based scoring system based on the Province of Manitoba evaluation procedure that has been used successfully in other studies (Bédard et al, 2008(Bédard et al, , 2010Gaudet et al, 2013;Weaver et al, 2009). …”

O frequencímetro Polar ® RS800CX é sensível à manobra de alteração postural

“…Nesse sentido, a utilização dos frequencímetros adaptados a registrar os RRi, tem sido justificada pelo seu baixo custo e fácil aplicação em ambiente laboratorial, externo ou ainda em condições da vida diária de um indivíduo. Frequencímetros de diferentes marcas e modelos vêm sendo utilizados em muitos estudos com VFC tanto em humanos [11][12][13][14][15]16,18 quanto em modelo animal 19,20 devido ao seu baixo custo e fácil manuseio 2,12 . Contudo, a literatura tem questionado a confiabilidade desses equipamentos, sugerindo cada vez mais estudos validando a utilização dos mesmos 13,17,22,23 .…”