Predictors of accidents in people with mild cognitive impairment, mild dementia due to Alzheimer's disease and healthy controls in simulated driving

Abstract

Objectives: To examine the driving variables that predict accident probability in mild dementia due to Alzheimer's disease (AD), mild cognitive impairment (MCI) and healthy older control drivers in simulated driving. To compare the three groups in mean performance and in frequency of scores exceeding 1.5 SD from the mean. Methods/Design: Participants were 37 drivers with MCI, 16 drivers with AD, and 21 control drivers over the age of 52. Driving measures were derived from four rural driving conditions: moderate traffic without and with distraction and high traffic without and with distraction. The measures were z-transformed based on the performance of 90 control drivers of different ages. Two unexpected incidents occurred per condition, requiring the sudden breaking to avoid an accident. Results: Drivers with AD showed significantly lower average speed, speed variability, greater headway distance, headway variability and average reaction time (RT) than control drivers. Drivers with MCI showed significantly lower average speed, greater headway distance and average RT than control drivers in the two conditions of distraction. No differences were found in accident probability. Drivers with AD had more deviant scores than both control drivers and drivers with MCI in most comparisons. Predictors of accident probability were average RT, speed variability and lateral position variability but MCI and AD status were not significant predictors in any of the regression models. Conclusions: Despite significant differences in performance, drivers with MCI and AD did not differ in accident probability from control drivers. An individualized approach of examining individual driving performance is recommended.

Driving Performance and Its Correlation with Neuropsychological Tests in Senior Drivers with Cognitive Impairment in Japan

“…1). More precisely, the responses of AD patients were slower than the SCD and MCI groups in simple reaction tests; but in the complex situation, there was no difference among the RT of the three groups (Table 3), which is in line with a recent study [53] reporting that drivers with AD showed significantly greater RT than control drivers in simulated driving. In addition, more than half the participants lacked stability of driving operations (see sim-dRT and com-dRT in Fig.…”

“…However, the simulator software used in our study did not measure the average speed of the participants. Economou et al [53] also pointed out the crawling problem of senior drivers, and interpreted it as a compensatory behavior to cope with the complex simulated traffic. Piersma et al [11] found that patients with AD drove significantly more slowly than healthy participants, when they were in a hurry or at the intersections.…”

Driving Ability Evaluation and Rehabilitation for People With Alzheimer’s Disease and Related Dementias

“…These simulators can collect data on parameters such as braking time and pressure, lane deviation, speed variability, and many other common driving safety errors in routine and high-pressure driving scenarios. Because of the advantage of keeping dependencies required by examining specific correlated driving abilities, simulated driving framework has been popularly applied in determining the correlation between different domains of cognitive deficits and operational driving abilities 16,18,19,21–34. According to the collected papers in this study, simulated driving test also provide the possibility for researchers to explore patients driving performance in some extreme situations (ie, collision,16,29 traffic25).…”

Aktuelle Evidenzlage zur Beurteilung der Fahrtauglichkeit von Menschen mit kognitiven Einschränkungen: Ein systematisches Review

“…und ist folgendermaßen aufgebaut: Pre-Test (z. B. Überprüfung von Basiswissen zur Fahrsicher- [24,26,27,29,31,36], insgesamt langsamer fuhren [21][22][23][24]36] und Probleme hatten die Fahrspur zu halten [22,24]. Weitere Auffälligkeiten waren langsamere Reaktionszeiten bei unerwarteten Ereignissen [21][22][23] und besonders großer Abstand zu anderen Fahrzeugen [22,23].…”