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Driving performance and its correlation with cognitive tests in elderly drivers with cognitive impairments
Author(s) -
Peng Zhouyuan,
Kinoshita Ayae
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.047202
Subject(s) - cognition , dementia , montreal cognitive assessment , trail making test , neuropsychology , psychology , population , cognitive test , test (biology) , correlation , medicine , clinical psychology , psychiatry , cognitive impairment , disease , environmental health , geometry , mathematics , paleontology , pathology , biology
Abstract Background With the rapid aging of the population, the driving problem of dementia patients has caused increasing concerns among the government, researchers and the public worldwide 1 . We aim to investigate driving behaviors of elderly drivers with cognitive impairments using a driving simulator. And we are further interested in exploring the correlation between neuropsychological tests and driving performance. Methods Elderly subjects with driving experience who visited the outpatient neurology clinic in the Kyoto university hospital for cognitive complaints from July 2018 to December 2019 were investigated. Cognitive tests were carried out, as well as a questionnaire asking both demographic and driving characteristics. Participants who wished to continue driving were asked to complete the driving tests. Results A total of 45 participants were included in the study, ranged in age from 66 to 92 years, of which 57.8% were male. Slightly more than half of participants have returned their driving licenses whereas 20 still hold a valid driving license. Though current drivers had better cognitive functions than retired drivers, poor performance was found on reaction, starting and stopping, signaling, and general. The score of Mini‐mental state examination (MMSE), trail making test (TMT), block design test (BDT) and Alzheimer’s disease assessment scale–cognitive subscale (ADAS‐Cog) were correlated with reaction tests, especially TMT‐B, revealing a slightly higher correlation coefficients for the choice reaction test. MMSE, BDT and ADAS‐Cog had quite high correlation coefficients for sudden braking ( ρ 1 =‐0.806, ρ 2 =‐0.727, ρ 3 =0.786, p <0.001). TMT‐B was associated with no signaling ( ρ 4 =0.625, p <0.05) while clock drawing test (CDT) had a correlation with wrong signaling ( ρ 5 =‐0.545, p <0.05). In addition, CDT also showed a negative correlation with going the wrong way ( ρ 6 =‐0.655, p <0.05). MMSE and ADAS‐Cog were moderately correlated with lateral control ( ρ 7 =‐0.620, ρ 8 =0.560, p <0.05). Conclusions Current elderly drivers had better cognitive functions, but a considerable part of them showed poor performance in the driving tests. Single cognitive tests were shown to have moderate to high correlations with specific driving maneuvers segmented from driving performance. Reference: Kim YJ, An H, Kim B, Park YS, Kim KW. An International Comparative Study on Driving Regulations on People with Dementia. J Alzheimers Dis . 2017;56(3):1007‐1014.