@article{4c5601585be54db3a1efc5ad75efe2f5,
title = "Driving cessation over a 24-year period: Dementia severity and cerebrospinal fluid biomarkers",
abstract = "Introduction: With 36 million older adult U.S. drivers, safety is a critical concern, particularly among those with dementia. It is unclear at what stage of Alzheimer's disease (AD) older adults stop driving and whether preclinical AD affects driving cessation. Methods: Time to driving cessation was examined based on Clinical Dementia Rating (CDR) and AD cerebrospinal fluid biomarkers. 1795 older adults followed up to 24 years received CDR ratings. A subset (591) had cerebrospinal fluid biomarker measurements and was followed up to 17 years. Differences in CDR and biomarker groups as predictors of time to driving cessation were analyzed using Kaplan-Meier curves and Cox proportional models. Results: Higher CDR scores and more abnormal biomarker measurements predicted a shorter time to driving cessation. Discussion: Higher levels of AD biomarkers, including among individuals with preclinical AD, lead to earlier driving cessation. Negative functional outcomes of preclinical AD show a nonbenign phase of the disease.",
keywords = "Aged, Alzheimer's disease, Amyloid β, Biomarker, Cerebrospinal fluid, Driving, Driving cessation, Older adults, Preclinical, Tau, ptau",
author = "Stout, {Sarah H.} and Babulal, {Ganesh M.} and Chunyu Ma and Carr, {David B.} and Head, {Denise M.} and Grant, {Elizabeth A.} and Williams, {Monique M.} and Holtzman, {David M.} and Fagan, {Anne M.} and Morris, {John C.} and Roe, {Catherine M.}",
note = "Funding Information: Funding for this study was provided by the National Institute on Aging ( R01 AG056466 , R01AG043434 , R01AG43434-03S1 , P50AG005681 , P01AG003991 , and P01AG026276 ); Fred Simmons and Olga Mohan, the Farrell Family Research Fund, and the Charles and Joanne Knight Alzheimer's Research Initiative of the Washington University Knight Alzheimer's Disease Research Center (ADRC). The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The authors thank the participants, investigators, and staff of the Knight ADRC Clinical Core for participant assessments, Genetics Core for APOE genotyping, and Biomarker Core for cerebrospinal fluid analysis. The authors gratefully acknowledge the expertise and suggestions offered by Dr. Brian Ott of Brown University for the submission of this manuscript. S.H.S. had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Publisher Copyright: {\textcopyright} 2017 the Alzheimer's Association",
year = "2018",
month = may,
doi = "10.1016/j.jalz.2017.11.011",
language = "English",
volume = "14",
pages = "610--616",
journal = "Alzheimer's and Dementia",
issn = "1552-5260",
number = "5",
}