Preliminary Investigation on the Association between Depressive Symptoms and Driving Performance in Heart Failure

Abstract

Heart failure (HF) patients commit many errors on driving simulation tasks and cognitive dysfunction appears to be one important contributor to impaired driving in HF. Clinical modifiers of cognition may also play a key role. In particular, depression is common in HF patients, linked with cognitive dysfunction, and contributes to reduced driving fitness in non-HF samples. However, the associations among depressive symptoms, cognition, and driving in HF are unclear. Eighteen HF patients completed a validated simulated driving scenario, the Beck Depression Inventory-II (BDI-II), and a cognitive test battery. Partial correlations controlling for demographic and medical confounds showed higher BDI-II score correlated with greater number of collisions, centerline crossings, and % time out of lane. Increased depressive symptoms correlated with lower attention/executive function, and reduced performance in this domain was associated with a greater number of collisions, centerline crossing, and % time out of lane. Depressive symptoms may be related to poorer driving performance in HF, perhaps through association with cognitive dysfunction. However, larger studies with on-road testing are needed to replicate our preliminary findings before recommendations for clinical practice can be made.

Driving performance of outpatients achieving discharge criteria after deep sedation is worse than these of their escort-driver: a prospective observational study on simulator

“…A power calculation based on previously published studies (19,20) found that a sample size of a total of 57 subjects (sum of patients and escorts) is required to demonstrate a difference of 3 midline traffic crossings, which we considered to represent a meaningful increase in the risk of accidents, with a power of 0.8 and an alpha of 0.05. Participants were recruited until complete data from 30 patients and 30 matched escorts were obtained.…”