Amnesia and driving

Anderson, Steven W.; Rizzo, Matthew; Skaar, Nicole R.; Stierman, Laura; Cavaco, Sara; Dawson, Jeffrey D.; Damásio, Hanna

doi:10.1080/13803390590954182

Cited by 26 publications

(16 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, the presence of memory impairments may interact with impairments in other cognitive domains relevant to driving. To isolate the effects of memory impairment in driving, Anderson et al (2007) found that drivers with severe amnesia due to bilateral hippocampal lesions were not impaired in most aspects of driving performance (knowledge of driving rules, safety procedures, and road sign meaning were normal), but presented some difficulties in following route directions on the road. A study from Grace et al (2005) that compared neuropsychological and driving performance in AD and Parkinson Disease patients found that severe memory impairment in the AD group (i.e., a cortical dementia with impaired learning, retrieval and recognition memory) did not relate to poor driving, but memory impairment in the unsafe Parkinson disease group (i.e., a subcortical dementia with impaired retrieval but relatively preserved recognition) reflected the influence of executive dysfunction on memory.…”

Section: Discussionmentioning

confidence: 99%

The Addenbrooke's Cognitive Examination Revised as a potential screening test for elderly drivers

Ferreira

Simões

Marôco

2012

Accident Analysis & Prevention

View full text Add to dashboard Cite

a b s t r a c tConsiderable research has shown that neuropsychological tests are predictive of real-world driving ability. The Mini-Mental State Examination (MMSE) is a brief cognitive test that has been commonly used in the assessment of older drivers. However, this test has inherent problems that limit its validity to evaluate cognitive abilities related to driving and to screen for driving impairments in non-demented people. Therefore, it is useful to test new screening instruments that may predict potential unsafe drivers who require an in-depth neuropsychological assessment in a specialised centre. To date, the utility of the Addenbrooke's Cognitive Examination Revised (ACE-R) as an indicator of driving ability has not been established. In the current study, fifty older drivers (mean age = 73.1 years) who were referred for a psychological assessment, the protocol of which included the ACE-R, underwent an on-road driving test. Using linear discriminant analyses, the results highlighted the higher classification accuracy of the ACE-R compared to the MMSE score, particularly for detecting unsafe drivers. Measures of visuospatial and executive functions, which are not incorporated in the MMSE score, had an incremental value in the prediction of driving ability. This emerging brief cognitive test may warrant additional study for use in the fitness to drive assessment of older adults.

show abstract

Section: Discussionmentioning

confidence: 99%

The Addenbrooke's Cognitive Examination Revised as a potential screening test for elderly drivers

Ferreira

Simões

Marôco

2012

Accident Analysis & Prevention

View full text Add to dashboard Cite

show abstract

“…However, driving during these evaluations may not provide a representative sample of a person's typical driving behavior, and there are limitations including practicality and expense, particularly if repeated assessment is needed to monitor possible changes in driving safety status (Brown & Ott, 2004). Performances on tests of driver knowledge, such as State licensing exams, may not reflect the person's application of that knowledge while driving, and also may be preserved even in the face of substantial acquired cognitive deficits, such as dense amnesia (e.g., Anderson et al, 2007). …”

Section: Introductionmentioning

confidence: 99%

Neuropsychological assessment of driving safety risk in older adults with and without neurologic disease

Anderson

Aksan

Dawson

et al. 2012

Journal of Clinical and Experimental Neuropsychology

View full text Add to dashboard Cite

Decline in cognitive abilities can be an important contributor to the driving problems encountered by older adults, and neuropsychological assessment may provide a practical approach to evaluating this aspect of driving safety risk. The purpose of the present study was to evaluate several commonly used neuropsychological tests in the assessment of driving safety risk in older adults with and without neurological disease. A further goal of this study was to identify brief combinations of neuropsychological tests that sample performances in key functional domains and thus could be used to efficiently assess driving safety risk. 345 legally licensed and active drivers over the age of 50, with either no neurologic disease (N=185), probable Alzheimer's disease (N=40), Parkinson's disease (N=91), or stroke (N=29), completed vision testing, a battery of 10 neuropsychological tests, and an 18 mile drive on urban and rural roads in an instrumented vehicle. Performances on all neuropsychological tests were significantly correlated with driving safety errors. Confirmatory factor analysis was used to identify 3 key cognitive domains assessed by the tests (speed of processing, visuospatial abilities, and memory), and several brief batteries consisting of one test from each domain showed moderate corrected correlations with driving performance. These findings are consistent with the notion that driving places demands on multiple cognitive abilities that can be affected by aging and age-related neurological disease, and that neuropsychological assessment may provide a practical off-road window into the functional status of these cognitive systems.

show abstract

“…The relationship of hippocampal volumes to driving ratings likely is not directly linked to the strong association of the hippocampus with declarative memory and amnesia 34 , as these neurocognitive processes are not central to deficits in driving performance 9,35 . Although memory impairment was associated with poor driving in a meta-analytic study of dementia patients, visuospatial skills were found to be more important 36 .…”

Section: Discussionmentioning

confidence: 99%

Lower Hippocampal Volume Predicts Decrements in Lane Control Among Drivers With Amnestic Mild Cognitive Impairment

Griffith

Okonkwo

Stewart

et al. 2013

J Geriatr Psychiatry Neurol

View full text Add to dashboard Cite

Objectives There are few methods to discern driving risks in patients with early dementia and Mild Cognitive Impairment (MCI). We aimed to determine whether structural MRI of the hippocampus – a biomarker of probable Alzheimer pathology and a measure of disease severity in those affected – is linked to objective ratings of on-road driving performance in older adults with and without amnestic MCI. Methods 49 consensus-diagnosed participants from an Alzheimer's Disease Research Center (15 diagnosed with amnestic MCI and 34 demographically similar controls) underwent structural MRI and on-road driving assessments. Results Mild atrophy of the left hippocampus was associated with less-than-optimal ratings in lane control but not with other discrete driving skills. Decrements in left hippocampal volume conferred higher risk for less-than-optimal lane control ratings in the MCI patients (B = −1.63, SE = .74, Wald = 4.85, P = .028), but not in controls (B = 0.13, SE = .415, Wald = 0.10, P = .752). The odds ratio (OR) and 95% confidence interval (CI) for below optimal lane control in the MCI group was 4.41 (1.18, 16.36), which was attenuated to 3.46 (0.88, 13.60) after accounting for the contribution of left hippocampal volume. Conclusion These findings suggest that there may be a link between hippocampal atrophy and difficulties with lane control in persons with amnestic MCI. Further study appears warranted to better discern patterns of brain atrophy in MCI and AD and whether these could be early markers of clinically meaningful driving risk.

show abstract

Amnesia and driving

Cited by 26 publications

References 18 publications

The Addenbrooke's Cognitive Examination Revised as a potential screening test for elderly drivers

The Addenbrooke's Cognitive Examination Revised as a potential screening test for elderly drivers

Neuropsychological assessment of driving safety risk in older adults with and without neurologic disease

Lower Hippocampal Volume Predicts Decrements in Lane Control Among Drivers With Amnestic Mild Cognitive Impairment

Contact Info

Product

Resources

About