Preclinical Alzheimer's disease and longitudinal driving decline

Catherine M. Roe, Ganesh M. Babulal, Denise M. Head, Sarah H. Stout, Elizabeth K. Vernon, Nupur Ghoshal, Brad Garland, Peggy P. Barco, Monique M. Williams, Ann Johnson, Rebecca Fierberg, M. Scot Fague, Chengjie Xiong, Elizabeth Mormino, Elizabeth A. Grant, David M. Holtzman, Tammie L.S. Benzinger, Anne M. Fagan, Brian R. Ott, David B. CarrJohn C. Morris

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Introduction 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.

Original languageEnglish
Pages (from-to)74-82
Number of pages9
JournalAlzheimer's and Dementia: Translational Research and Clinical Interventions
Volume3
Issue number1
DOIs
StatePublished - Jan 1 2017

Keywords

  • Aged
  • Alzheimer's disease
  • Amyloid imaging
  • Biomarker
  • Cerebrospinal fluid
  • Driving
  • Functional outcome
  • Older adults
  • Preclinical
  • Ptau
  • Road test
  • Tau

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