A 2.5-Year Longitudinal Assessment of Naturalistic Driving in Preclinical Alzheimer's Disease
A 2.5-Year Longitudinal Assessment of Naturalistic Driving in Preclinical Alzheimer's Disease
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DOI：
10.3233/jad-181242
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发表时间：
2019-01-01
影响因子：
4
通讯作者：
Babulal, Ganesh M.
中科院分区：
文献类型：
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作者：
Roe, Catherine M.;Stout, Sarah H.;Babulal, Ganesh M.
背景资料：新出现的证据表明，与没有临床前阿尔茨海默病（AD）的老年人相比，患有临床前AD的认知正常老年人犯更多错误，并且更有可能在标准化道路测试中获得边缘/失败评级，但临床前AD对日常驾驶行为的影响程度尚不清楚。目的：检查有和没有临床前AD的人自我报告和自然纵向驾驶行为。方法：我们前瞻性地随访了认知正常的驾驶员（年龄65岁以上）（n = 10）和无临床前AD（n = 10）2.5年。使用淀粉样蛋白正电子发射断层扫描（PET）和匹兹堡化合物B评估临床前AD。驾驶习惯问卷调查评估了自我报告的驾驶结果。使用插入每个参与者车辆的车载诊断II端口的商业GPS数据记录器捕获自然驾驶。每30秒对数据进行采样，并记录所有超速、急刹车和突然加速的情况。结果：临床前AD参与者去的地方/独特的目的地更少，旅行的天数更少，旅行次数也比没有临床前AD的参与者少。临床前AD组报告了更小的驾驶空间，对其他驾驶员的依赖性更大，以及由于视力困难而导致的驾驶困难。临床前AD的人有更少的行程与任何侵略，并表现出更大的下降，在整个2.5年的随访期间，每月驾驶的天数和1-5英里之间的行程数。结论：即使在AD的临床前阶段，驾驶的变化也会发生。
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.