Driving difficulties among patients with Alzheimer's disease and other neurodegenerative disorders

Anselm B.M. Fuermaier; Dafne Piersma; Dick de Waard; Ragnhild J. Davidse; Jolieke de Groot; Michelle J A Doumen; Ruud A. Bredewoud; René Claesen; Afina W. Lemstra; Philip Scheltens; Annemiek Vermeeren; Rudolf Ponds; Frans Verhey; Peter Paul De Deyn; Wiebo H. Brouwer; Oliver Tucha

doi:10.3233/JAD-181095

Driving difficulties among patients with Alzheimer's disease and other neurodegenerative disorders

Anselm B.M. Fuermaier^*, Dafne Piersma, Dick de Waard, Ragnhild J. Davidse, Jolieke de Groot, Michelle J A Doumen, Ruud A. Bredewoud, René Claesen, Afina W. Lemstra, Philip Scheltens, Annemiek Vermeeren, Rudolf Ponds, Frans Verhey, Peter Paul De Deyn, Wiebo H. Brouwer, Oliver Tucha

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND/OBJECTIVE: Neurodegenerative disorders impact fitness to drive of older drivers, but on-road driving studies investigating patients with different neurodegenerative disorders are scarce. A variety of driving errors have been reported in patients with Alzheimer's disease (AD), but it is unclear which types of driving errors occur most frequently. Moreover, patients with other neurodegenerative disorders than AD typically present with different symptoms and impairments, therefore different driving errors may be expected.

METHODS: Patients with AD (n = 80), patients with other neurodegenerative disorders with cognitive decline (i.e., vascular dementia, frontotemporal dementia, dementia with Lewy bodies/Parkinson's disease, n = 59), and healthy older drivers (n = 45) participated in a fitness-to-drive assessment study including on-road driving.

RESULTS: Patients with AD performed significantly worse than healthy older drivers on operational, tactical, visual, and global aspects of on-road driving. In patients with AD, on-road measures were significantly associated with 'off-road' measures. Patients with neurodegenerative disorders other than AD showed large overlap in the types of driving errors. Several driving errors were identified that appear to be characteristic for patients with particular neurodegenerative disorders.

CONCLUSION: Patients from each group of neurodegenerative disorders commonly display tactical driving errors regarding lane positioning, slow driving, observation of the blind spot, and scanning behavior. Several other tactical and operational driving errors, including not communicating with cyclists and unsteady steering, were more frequently observed in patients with non-AD neurodegenerative disorders. These findings have implications for on-road and 'off-road' fitness-to-drive assessments for patients with neurodegenerative disorders with cognitive decline.

Original language	English
Pages (from-to)	1019-1030
Number of pages	12
Journal	Journal of Alzheimer's Disease
Volume	69
Issue number	4
Early online date	30 Apr 2019
DOIs	https://doi.org/10.3233/JAD-181095
Publication status	Published - 2019

Keywords

ACCURACY
Alzheimer's disease
CLINICAL-DIAGNOSIS
CRITERIA
DEMENTIA
DRIVERS
FITNESS
PARKINSONS-DISEASE
PEOPLE
PERFORMANCE
Parkinson's disease
ROAD TEST
automobile driving
cognitive decline
dementia with Lewy bodies
frontotemporal dementia
neurodegenerative diseases
vascular dementia

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10.3233/JAD-181095

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Cite this

Fuermaier, A. B. M., Piersma, D., de Waard, D., Davidse, R. J., de Groot, J., Doumen, M. J. A., Bredewoud, R. A., Claesen, R., Lemstra, A. W., Scheltens, P., Vermeeren, A., Ponds, R., Verhey, F., De Deyn, P. P., Brouwer, W. H., & Tucha, O. (2019). Driving difficulties among patients with Alzheimer's disease and other neurodegenerative disorders. Journal of Alzheimer's Disease, 69(4), 1019-1030. https://doi.org/10.3233/JAD-181095

@article{bc1666382f2a45d29b82c798b302ff43,

title = "Driving difficulties among patients with Alzheimer's disease and other neurodegenerative disorders",

abstract = "BACKGROUND/OBJECTIVE: Neurodegenerative disorders impact fitness to drive of older drivers, but on-road driving studies investigating patients with different neurodegenerative disorders are scarce. A variety of driving errors have been reported in patients with Alzheimer's disease (AD), but it is unclear which types of driving errors occur most frequently. Moreover, patients with other neurodegenerative disorders than AD typically present with different symptoms and impairments, therefore different driving errors may be expected.METHODS: Patients with AD (n = 80), patients with other neurodegenerative disorders with cognitive decline (i.e., vascular dementia, frontotemporal dementia, dementia with Lewy bodies/Parkinson's disease, n = 59), and healthy older drivers (n = 45) participated in a fitness-to-drive assessment study including on-road driving.RESULTS: Patients with AD performed significantly worse than healthy older drivers on operational, tactical, visual, and global aspects of on-road driving. In patients with AD, on-road measures were significantly associated with 'off-road' measures. Patients with neurodegenerative disorders other than AD showed large overlap in the types of driving errors. Several driving errors were identified that appear to be characteristic for patients with particular neurodegenerative disorders.CONCLUSION: Patients from each group of neurodegenerative disorders commonly display tactical driving errors regarding lane positioning, slow driving, observation of the blind spot, and scanning behavior. Several other tactical and operational driving errors, including not communicating with cyclists and unsteady steering, were more frequently observed in patients with non-AD neurodegenerative disorders. These findings have implications for on-road and 'off-road' fitness-to-drive assessments for patients with neurodegenerative disorders with cognitive decline.",

keywords = "ACCURACY, Alzheimer's disease, CLINICAL-DIAGNOSIS, CRITERIA, DEMENTIA, DRIVERS, FITNESS, PARKINSONS-DISEASE, PEOPLE, PERFORMANCE, Parkinson's disease, ROAD TEST, automobile driving, cognitive decline, dementia with Lewy bodies, frontotemporal dementia, neurodegenerative diseases, vascular dementia",

author = "Fuermaier, {Anselm B.M.} and Dafne Piersma and {de Waard}, Dick and Davidse, {Ragnhild J.} and {de Groot}, Jolieke and Doumen, {Michelle J A} and Bredewoud, {Ruud A.} and Ren{\'e} Claesen and Lemstra, {Afina W.} and Philip Scheltens and Annemiek Vermeeren and Rudolf Ponds and Frans Verhey and {De Deyn}, {Peter Paul} and Brouwer, {Wiebo H.} and Oliver Tucha",

year = "2019",

doi = "10.3233/JAD-181095",

language = "English",

volume = "69",

pages = "1019--1030",

journal = "Journal of Alzheimer's Disease",

issn = "1387-2877",

publisher = "IOS Press",

number = "4",

}

Fuermaier, ABM, Piersma, D, de Waard, D, Davidse, RJ, de Groot, J, Doumen, MJA, Bredewoud, RA, Claesen, R, Lemstra, AW, Scheltens, P, Vermeeren, A, Ponds, R, Verhey, F, De Deyn, PP, Brouwer, WH & Tucha, O 2019, 'Driving difficulties among patients with Alzheimer's disease and other neurodegenerative disorders', Journal of Alzheimer's Disease, vol. 69, no. 4, pp. 1019-1030. https://doi.org/10.3233/JAD-181095

TY - JOUR

T1 - Driving difficulties among patients with Alzheimer's disease and other neurodegenerative disorders

AU - Fuermaier, Anselm B.M.

AU - Piersma, Dafne

AU - de Waard, Dick

AU - Davidse, Ragnhild J.

AU - de Groot, Jolieke

AU - Doumen, Michelle J A

AU - Bredewoud, Ruud A.

AU - Claesen, René

AU - Lemstra, Afina W.

AU - Scheltens, Philip

AU - Vermeeren, Annemiek

AU - Ponds, Rudolf

AU - Verhey, Frans

AU - De Deyn, Peter Paul

AU - Brouwer, Wiebo H.

AU - Tucha, Oliver

PY - 2019

Y1 - 2019

N2 - BACKGROUND/OBJECTIVE: Neurodegenerative disorders impact fitness to drive of older drivers, but on-road driving studies investigating patients with different neurodegenerative disorders are scarce. A variety of driving errors have been reported in patients with Alzheimer's disease (AD), but it is unclear which types of driving errors occur most frequently. Moreover, patients with other neurodegenerative disorders than AD typically present with different symptoms and impairments, therefore different driving errors may be expected.METHODS: Patients with AD (n = 80), patients with other neurodegenerative disorders with cognitive decline (i.e., vascular dementia, frontotemporal dementia, dementia with Lewy bodies/Parkinson's disease, n = 59), and healthy older drivers (n = 45) participated in a fitness-to-drive assessment study including on-road driving.RESULTS: Patients with AD performed significantly worse than healthy older drivers on operational, tactical, visual, and global aspects of on-road driving. In patients with AD, on-road measures were significantly associated with 'off-road' measures. Patients with neurodegenerative disorders other than AD showed large overlap in the types of driving errors. Several driving errors were identified that appear to be characteristic for patients with particular neurodegenerative disorders.CONCLUSION: Patients from each group of neurodegenerative disorders commonly display tactical driving errors regarding lane positioning, slow driving, observation of the blind spot, and scanning behavior. Several other tactical and operational driving errors, including not communicating with cyclists and unsteady steering, were more frequently observed in patients with non-AD neurodegenerative disorders. These findings have implications for on-road and 'off-road' fitness-to-drive assessments for patients with neurodegenerative disorders with cognitive decline.

AB - BACKGROUND/OBJECTIVE: Neurodegenerative disorders impact fitness to drive of older drivers, but on-road driving studies investigating patients with different neurodegenerative disorders are scarce. A variety of driving errors have been reported in patients with Alzheimer's disease (AD), but it is unclear which types of driving errors occur most frequently. Moreover, patients with other neurodegenerative disorders than AD typically present with different symptoms and impairments, therefore different driving errors may be expected.METHODS: Patients with AD (n = 80), patients with other neurodegenerative disorders with cognitive decline (i.e., vascular dementia, frontotemporal dementia, dementia with Lewy bodies/Parkinson's disease, n = 59), and healthy older drivers (n = 45) participated in a fitness-to-drive assessment study including on-road driving.RESULTS: Patients with AD performed significantly worse than healthy older drivers on operational, tactical, visual, and global aspects of on-road driving. In patients with AD, on-road measures were significantly associated with 'off-road' measures. Patients with neurodegenerative disorders other than AD showed large overlap in the types of driving errors. Several driving errors were identified that appear to be characteristic for patients with particular neurodegenerative disorders.CONCLUSION: Patients from each group of neurodegenerative disorders commonly display tactical driving errors regarding lane positioning, slow driving, observation of the blind spot, and scanning behavior. Several other tactical and operational driving errors, including not communicating with cyclists and unsteady steering, were more frequently observed in patients with non-AD neurodegenerative disorders. These findings have implications for on-road and 'off-road' fitness-to-drive assessments for patients with neurodegenerative disorders with cognitive decline.

KW - ACCURACY

KW - Alzheimer's disease

KW - CLINICAL-DIAGNOSIS

KW - CRITERIA

KW - DEMENTIA

KW - DRIVERS

KW - FITNESS

KW - PARKINSONS-DISEASE

KW - PEOPLE

KW - PERFORMANCE

KW - Parkinson's disease

KW - ROAD TEST

KW - automobile driving

KW - cognitive decline

KW - dementia with Lewy bodies

KW - frontotemporal dementia

KW - neurodegenerative diseases

KW - vascular dementia

U2 - 10.3233/JAD-181095

DO - 10.3233/JAD-181095

M3 - Article

C2 - 31045516

SN - 1387-2877

VL - 69

SP - 1019

EP - 1030

JO - Journal of Alzheimer's Disease

JF - Journal of Alzheimer's Disease

IS - 4

ER -