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Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease

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Cognitive Decline and Older Driver Crash Risk.

Laura A Fraade-Blanar¹, Beth E Ebel^1,2,3, Eric B Larson⁴

¹Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, Washington.

Journal of the American Geriatrics Society

|April 19, 2018

Summary

Cognitive decline in older drivers without dementia is linked to increased crash risk. Poorer performance on cognitive tests, like the CASI-IRT, predicts higher motor vehicle crash rates in this population.

Keywords:

cognition cognitive measurement dementia motor vehicle crash older drivers

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Area of Science:

Gerontology
Neuroscience
Public Health

Background:

Cognitive impairment is a known risk factor for driving errors.
Identifying at-risk older drivers without dementia is crucial for road safety.
Existing research often focuses on diagnosed dementia, leaving a gap in understanding risk in milder cognitive decline.

Purpose of the Study:

To investigate the association between cognitive function and automobile crash risk in older drivers without dementia.
To determine if the level of cognitive function or the rate of cognitive decline predicts crash involvement.

Main Methods:

Retrospective analysis of a longitudinal cohort study (Adult Changes in Thought - ACT Study) merged with crash and licensure data (2002-2015).
Cognitive function assessed using the Cognitive Abilities Screening Instrument scored using item response theory (CASI-IRT).
Negative binomial mixed-effects models analyzed crash risk, considering covariates like age, sex, and medical comorbidities.

Main Results:

Over 7 years, 13% of 2,615 older drivers experienced at least one crash.
A 1-unit decrease in CASI-IRT score was associated with a 26% increased crash rate (IRR=1.26, CI=1.08-1.51).
Cognitive decline rate between visits did not significantly predict crash risk.

Conclusions:

Poorer cognitive performance, as measured by CASI-IRT, is a risk factor for motor vehicle crashes in older drivers without dementia.
These findings highlight the need for further research into driving behaviors and decision-making support for older adults with cognitive impairments.