Preclinical Alzheimer's disease and longitudinal driving decline

Alzheimer's and Dementia: Translational Research and Clinical Interventions - Tập 3 - Trang 74-82 - 2017
Catherine M. Roe1,2, Ganesh M. Babulal1,3, Denise M. Head1,4, Sarah H. Stout1,2, Elizabeth K. Vernon1,2, Nupur Ghoshal1,2, Brad Garland5, Peggy P. Barco6,7, Monique M. Williams8, Ann Johnson9,10, Rebecca Fierberg1,2, M. Scot Fague1,11, Chengjie Xiong1,11, Elizabeth Mormino12, Elizabeth A. Grant1,11, David M. Holtzman1,2, Tammie L.S. Benzinger1,13,14, Anne M. Fagan1,2, Brian R. Ott15, David B. Carr16,7
1Department of Neurology, Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
2Department of Neurology, Washington University School of Medicine, St. Louis, Mo. USA
3Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
4Department of Psychology, Washington University School of Medicine, St. Louis, MO, USA
5My Tutor Learning Center, Belleville, IL, USA
6Department of Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
7The Rehabilitation Institute of St. Louis, St. Louis, MO, USA
8VITAS Healthcare, St. Louis, MO, USA
9Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
10Center for Clinical Studies, Washington University School of Medicine, St. Louis, MO, USA
11Division of Biostatistics, Washington University School of Medicine, St. Louis, Mo. USA
12Center for Alzheimer's Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
13Department of Radiology, Washington University School of Medicine, St. Louis, MO USA
14Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
15Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA
16Department of Medicine, Washington University School of Medicine, St. Louis, Mo., USA

Tóm tắt

AbstractIntroduction

Links between preclinical Alzheimer's disease (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

One hundred four 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 cerebrospinal fluid (CSF) tau/Aβ42 and phosphorylated tau (ptau181)/Aβ42 ratios, but not uptake on Pittsburgh compound B 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.


Tài liệu tham khảo

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Alzheimer's and Dementia: Translational Research and Clinical Interventions

Tập 3

74-82

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