Preclinical Alzheimer's disease and longitudinal driving decline
Catherine M Roe1,2, Ganesh M Babulal1,2, Denise M Head1,3
1Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine.
Introduction:
Links between preclinical AD and driving difficulty onset would support the use of driving performance as an outcome in primary and secondary prevention trials among older adults (OAs). We examined whether AD biomarkers predicted the onset of driving difficulties among OAs.
Methods:
104 OAs (65+ years) with normal cognition took part in biomarker measurements, a road test, clinical and psychometric batteries and self-reported their driving habits.
Results:
Higher values of CSF tau/Aβ42 and ptau181/Aβ42 ratios, but not uptake on PIB amyloid imaging (p=.12), predicted time to a rating of Marginal or Fail on the driving test using Cox proportional hazards models. Hazards ratios (95% confidence interval) were 5.75 (1.70-19.53), p=.005 for CSF tau/Aβ42; 6.19 (1.75-21.88) and p=.005 for CSF ptau181/Aβ42.
Discussion:
Preclinical AD predicted time to receiving a Marginal or Fail rating on an on-road driving test. Driving performance shows promise as a functional outcome in AD prevention trials.
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