Vestibular Dysfunction and Difficulty with Driving: Data from the 2001–2004 National Health and Nutrition Examination Surveys

Wei, Eric X.; Agrawal, Yuri

doi:10.3389/fneur.2017.00557

Cited by 22 publications

(21 citation statements)

References 55 publications

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“…More generally, Wei and Agrawal (2017) reported from a study of driving difficulty associated with vestibular dysfunction that women exhibited greater difficulty driving than men (P Յ 0.0013). In a study of cognitive performance in patients with vestibular loss and Alzheimer's disease, they reported that women performed worse in the Money Road Map Test than men, making 6.4 more errors (95% CI: 2.1-10.6; Wei et al 2018).…”

Section: Bilateral Vestibular Lossmentioning

confidence: 95%

Sexual dimorphism in vestibular function and dysfunction

Smith

Agrawal

Darlington

2019

Journal of Neurophysiology

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It has been recognized for some time that females appear to be overrepresented in the incidence of many vestibular disorders, and recent epidemiological studies further support this idea. While it is possible that this is due to a reporting bias, another possibility is that there are actual differences in the incidence of vestibular dysfunction between males and females. If this is true, it could be due to a sexual dimorphism in vestibular function and therefore dysfunction, possibly related to the hormonal differences between females and males, although the higher incidence of vestibular dysfunction in females appears to last long after menopause. Many other neurochemical differences exist between males and females, however, that could be implicated in sexual dimorphism. This review critically explores the possibility of sexual dimorphism in vestibular function and dysfunction, and the implications it may have for the treatment of vestibular disorders.

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Section: Bilateral Vestibular Lossmentioning

confidence: 95%

Sexual dimorphism in vestibular function and dysfunction

Smith

Agrawal

Darlington

2019

Journal of Neurophysiology

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“…Individuals with a vestibular disorder had difficulty driving under conditions where useful visual cues were reduced, precise spatial navigation skills were needed, and rapid head movements were elicited, and they reported having to pull off the road due to vertigo in some cases. In an analysis of data from the 2001-2004 National Health and Nutrition Examination Survey study, Wei et al 47 evaluated the influence of vestibular dysfunction on driving difficulty in Americans aged ≥50 years (N = 3071). They found that vestibular dysfunction was associated with self-reported driving difficulty; those with clinically symptomatic (vs self-reported) vestibular dysfunction had a 4-fold increase in odds of reporting difficulty with driving.…”

Section: Impact Of Migraine Symptoms On Driving Perfor-mentioning

confidence: 99%

The Influence of Migraine on Driving: Current Understanding, Future Directions, and Potential Implications of Findings

et al. 2019

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Objective.-To review the published findings relevant to migraine and driving performance, with an intent to encourage discussion on research which may broaden understanding in this area and help educate healthcare providers and their patients. Background.-Motor vehicle crashes result in more than 35,000 deaths and more than 2 million injuries annually in the United States. Migraine is one of the most prevalent diseases in the world, and many symptoms associated with migraine attacks have the potential to negatively influence driving ability. Methods.-We reviewed the published findings related to migraine and driving performance. Study findings relevant to symptoms of migraine and their potential effect on driving were also reviewed. This required a more expansive exploration of the literature beyond migraine, for example, review of the literature relating to the effect of pain, sleepiness, visual disturbances, or vertigo on driving. Finally, the potential effects of treatment for migraine on driving were reviewed. Results.-Literature on the effect of migraine on driving performance is sparse and, in general published studies on the topic have a number of limitations. Based on review of the literature pertaining to other disorders, it seems feasible that some symptoms occurring as part of the migraine attack could impact driving performance, although formal study in this area is lacking. Many of the approved treatments for migraine have the potential to impact driving, yet this has not been specifically studied, and the extent to which these risks are communicated to patients is not clear. Conclusion.-The impact of migraine on driving performance has been largely neglected, with few studies specifically designed to address the topic, and relevant studies were generally small with limited control of confounders. This area requires more focus, given a potential for impact on road safety.

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“…Studies in patients with specific vestibular disorders found that 60% of patients with Menière’s disease found driving to be either difficult or dangerous to perform [37], and 30% of patients with vestibular schwannomas experienced driving difficulty following surgical resection of their tumors [38]. Recently published data from the National Health and Nutrition Examination Survey (NHANES) found that individuals with symptomatic vestibular dysfunction had an over four-fold odds of experiencing driving difficulty relative to individuals without vestibular dysfunction [39]. Furthermore, when assessing specific driving conditions, one study found that vestibular patients have particularly greater difficulty with driving tasks that require spatial navigation such as changing lanes in traffic, staying in lane, and pulling into or out of parking spaces as well as with driving tasks where vision was limited such as driving at night or in the rain [40].…”

Section: Discussionmentioning

confidence: 99%

Saccular Impairment in Alzheimer’s Disease Is Associated with Driving Difficulty

Wei

Harun

et al. 2017

Dement Geriatr Cogn Disord

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Background/Aims: Patients with Alzheimer’s disease (AD) experience increased rates of vestibular loss. Recent studies suggest that saccular impairment in mild cognitive impairment (MCI) and AD patients is associated with impaired spatial cognitive function. However, the impact of saccular impairment on everyday behaviors that rely on spatial cognitive function is unknown. Methods: We recruited 60 patients (21 MCI and 39 AD) from an interdisciplinary Memory Clinic. Saccular function was measured, and a visuospatial questionnaire was administered to assess whether participants experienced impairments in terms of driving difficulty, losing objects, falls, and fear of falling. Results: In multiple logistic regression analyses, MCI and AD patients with bilateral saccular impairment had a significant, greater than 12-fold odds of driving difficulty (OR 12.1, 95% CI 1.2, 117.7) compared to MCI and AD patients with normal saccular function, and the association appears to be mediated by spatial cognition as measured by the Money Road Map Test. Conclusion: This study suggests a novel link between saccular impairment and driving difficulty in MCI and AD patients and demonstrates that driving difficulty may be a real-world manifestation of impaired spatial cognition associated with saccular impairment.

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Vestibular Dysfunction and Difficulty with Driving: Data from the 2001–2004 National Health and Nutrition Examination Surveys

Cited by 22 publications

References 55 publications

Sexual dimorphism in vestibular function and dysfunction

Sexual dimorphism in vestibular function and dysfunction

The Influence of Migraine on Driving: Current Understanding, Future Directions, and Potential Implications of Findings

Saccular Impairment in Alzheimer’s Disease Is Associated with Driving Difficulty

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