On-road assessment of fitness-to-drive in persons with MS with cognitive impairment: A prospective study

Multiple Sclerosis Journal - Tập 24 Số 11 - Trang 1499-1506 - 2018
Sarah A. Morrow1, Sherrilene Classen2, Miriam Monahan3, Tim Danter4, Robert Taylor5, Sarah Krasniuk6, Heather Rosehart1, Wenqing He5
1Department of Clinical Neurological Sciences, London Health Sciences Center, Western University, London, ON, Canada
2School of Occupational Therapy, Western University, London, ON, Canada/Department of Occupational Therapy, University of Florida, Gainesville, FL, USA
3School of Occupational Therapy, Western University, London, ON, Canada/The Driver Rehabilitation Institute, Santa Rosa, CA, USA
4School of Occupational Therapy, Western University, London, ON, Canada/All Dominion Driver Training and Traffic Education Centres Limited, Oakville, ON, Canada
5Department of Statistical and Actuarial Sciences, Western University, London, ON, Canada
6School of Occupational Therapy, Western University, London, ON, Canada

Tóm tắt

Background: Cognitive impairment is common in multiple sclerosis (MS). In other populations, cognitive impairment is known to affect fitness-to-drive. Few studies have focused on fitness-to-drive in MS and no studies have solely focused on the influence of cognitive impairment. Objective: To assess fitness-to-drive in persons with MS with cognitive impairment and low physical disability. Methods: Persons with MS, aged 18–59 years with EDSS ⩽ 4.0, impaired processing speed, and impairment on at least one measure of memory or executive function, were recruited. Cognition was assessed using the Minimal Assessment of Cognitive Function battery. A formal on-road driving assessment was conducted. Chi-square analysis examined the association between the fitness-to-drive (pass/fail) and the neuropsychological test results (normal/impaired). Bayesian statistics predicting failure of the on-road assessment were calculated. Results: Of 36 subjects, eight (22.2%) were unfit to drive. Only the BVMTR-IR, measuring visual-spatial memory, predicted on-road driving assessment failure ( X2 ( df = 1, N = 36) = 3.956; p = 0.047) with a sensitivity of 100%, but low specificity (35.7%) due to false positives (18/25). Conclusion: In persons with MS and impaired processing speed, impairment on the BVMTR-IR should lead clinicians to address fitness-to-drive.

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Multiple Sclerosis Journal

Tập 24 Số 11

1499-1506

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