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P4–113: A case of neurosyphilis with dementia and occipital lobe hypometabolism on 18FFDG‐PET
Author(s) -
Kasanuki Koji,
Iseki Eizo,
Fujishiro Hiroshige,
Chiba Yuhei,
Ota Kazumi,
Sato Kiyoshi,
Arai Heii
Publication year - 2013
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 - 10.1016/j.jalz.2013.05.1503
Subject(s) - neurosyphilis , dementia , medicine , atrophy , lumbar puncture , cognitive decline , psychology , pediatrics , cerebrospinal fluid , syphilis , disease , family medicine , human immunodeficiency virus (hiv)
accurately predicts driving safety. Methods: 45 patients at the Banner Alzheimer’s Institute received a driving test, either an on-road test or driving simulator. Analyses were conducted on the following variables to assess possible relationship of Passing, Failing, or Passing with Restrictions (PwR): age, sex, years of education, cognitive diagnosis, MMSE (total score and pentagons), MoCA (total score, trails, cube copy, and clock), informant concerns about driving, and location of driving test. Results: Univariate analyses demonstrate that patients in Pass, Fail, and PwR groups differed in terms of patient age (KW ANOVA p1⁄40.0312), MMSE-pentagon score (KW ANOVA p1⁄40.0279) and informant concerns about driving (Fisher’s exact p1⁄40.009). All other variables showed no significant difference (KWANOVA or Fisher’s exact p>0.05). In the pair-wise multiple comparison tests, patients in the Pass group showed a trend of having lower age than those in the Fail group (72.964.1 compared to 76.867.3, Multiple comparisons p1⁄40.061). MMSE-Pentagon score did not survive the multiple comparison tests (p>0.05). 91% of the patients who failed the driving test had informants with concerns for safety, compared to 38% of patients who passed (p1⁄40.000434, unadjusted for multiple comparison) and 38% who passed with restriction (p1⁄40.0407, unadjusted). Multivariate analysis with the General Classification and Regression Tree (GC&RT) created an algorithm (see figure) demonstrating that age, MMSE total score, MOCA-total score, MMSE-pentagon, MOCA-clock, and informant concerns with driving are useful in predicting outcome of the driving test. Conclusions: Further studies with larger population size are needed to help validate and improve the proposed algorithm to guide clinicians in determining driving safety in patients with dementia. Preliminary data suggest that age, MMSE total score, MOCA-total score, MMSE-pentagon, MOCA-Clock, and, informant concerns with driving may be associated with the driving test outcome.