Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-25T05:08:43.889Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological deficits associated with driving performance in Parkinson's and Alzheimer's disease

Published online by Cambridge University Press:  21 October 2005

JANET GRACE ,
MELISSA M. AMICK ,
ANELYSSA D'ABREU ,
ELENA K. FESTA ,
WILLIAM C. HEINDEL  and
BRIAN R. OTT
JANET GRACE
Affiliation:
Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
MELISSA M. AMICK
Affiliation:
Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
ANELYSSA D'ABREU
Affiliation:
Department of Clinical Neurosciences, Brown University, Providence, Rhode Island
ELENA K. FESTA
Affiliation:
Department of Psychology, Brown University, Providence, Rhode Island
WILLIAM C. HEINDEL
Affiliation:
Department of Psychology, Brown University, Providence, Rhode Island
BRIAN R. OTT
Affiliation:
Department of Clinical Neurosciences, Brown University, Providence, Rhode Island
Get access Rights & Permissions [Opens in a new window]

Abstract

Neuropsychological and motor deficits in Parkinson's disease that may contribute to driving impairment were examined in a cohort study comparing patients with Parkinson's disease (PD) to patients with Alzheimer's disease (AD) and to healthy elderly controls. Nondemented individuals with Parkinson's disease [Hoehn & Yahr (H&Y) stage I–III], patients with Alzheimer's disease [Clinical Demetia Rating scale (CDR) range 0–1], and elderly controls, who were actively driving, completed a neuropsychological battery and a standardized road test administered by a professional driving instructor. On-road driving ability was rated on number of driving errors and a global rating of safe, marginal, or unsafe. Overall, Alzheimer's patients were more impaired drivers than Parkinson's patients. Parkinson's patients distinguished themselves from other drivers by a head-turning deficiency. Drivers with neuropsychological impairment were more likely to be unsafe drivers in both disease groups compared to controls. Compared to controls, unsafe drivers with Alzheimer's disease were impaired across all neuropsychological measures except finger tapping. Driving performance in Parkinson's patients was related to disease severity (H&Y), neuropsychological measures [Rey Osterreith Complex Figure (ROCF), Trails B, Hopkins Verbal List Learning Test (HVLT)-delay], and specific motor symptoms (axial rigidity, postural instability), but not to the Unified Parkinson Disease Rating Scale (UPDRS) motor score. Multifactorial measures (ROCF, Trails B) were useful in distinguishing safe from unsafe drivers in both patient groups. (JINS, 2005, 11, 766–775.)

Keywords

DementiaMotor vehiclesCognitionMemoryNeurodegenerative diseasesBasal ganglia
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 6 , October 2005 , pp. 766 - 775
Copyright
© 2005 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Benedict, R. (1998). Hopkins Verbal Learning Test–Revised. Lutz, FL: Psychological Assessment Resources.
Brown, L.B. & Ott, B.R. (2004). Driving and dementia: A review of the literature. Journal of Geriatric Psychiatry & Neurology, 17, 232–240.Google Scholar
Brown, L.B., Ott, B.R., Papandonatos, G.D., Sui, Y., Ready, R.E., & Morris, J.C. (2005a). Prediction of on-road driving performance in patients with early Alzheimer's disease. Journal of the American Geriatrics Society, 53, 94–98.Google Scholar
Brown, L.B., Stern, R.A., Cahn-Weiner, D.A., Rogers, B., Messer, M.A., Lannon, M.C., Maxell, C., Souza, T., White, T., & Ott, B.R. (2005b). Driving Scenes test of the Neuropsychological Assessment Battery (NAB) and on-road driving performance in aging and very mild dementia. Archives of Clinical Neuropsychology, 20, 209–216.Google Scholar
Drachman, D.A. & Swearer, J.M. (1993). Driving and Alzheimer's disease: The risk of crashes. Neurology, 43, 2448–2456.Google Scholar
Dubinsky, R.M., Gray, C., Husted, D., Busenbark, K., Vetere-Overfield, B., Wiltfong, D., Parrish, D., & Koller, W.C. (1991). Driving in Parkinson's disease. Neurology, 41, 517–520.Google Scholar
Duchek, J.M., Carr, D.B., Hun, L., Roe, C.M., Xiong, C., Shah, K., & Morris, J.C. (2003). Longitudinal driving performance in early-stage dementia of the Alzheimer's type. Journal of the American Geriatrics Society, 51, 1342–1347.Google Scholar
Duff, K., Shoenberg, M.R., Scott, J.G., & Adams, R.L. (2005). The relationship between executive functioning and verbal and visual learning and memory. Archives of Clinical Neuropsychology, 20, 111–122.Google Scholar
Fahn, S., Elton, R.L., & Members of the UPDRS Development Committee. (1987). Unified Parkinson's Disease Rating Scale. In S. Fahn, C.D. Marsden, M. Goldstein, D.B. Calne, (Eds.), Recent Developments in Parkinson's Disease, Vol. 2, (pp. 153–163, 293–304). Florham Park, NJ: Macmillan Healthcare Information.
Fitten, L.J., Perryman, K.M., Wilkinson, C.J., Little, R.J., Burns, M.M., Pachana, N., Mervis, J.R., Malmgren, R., Siembieda, D.W., & Ganzell, S. (1995). Alzheimer and vascular dementias and driving. Journal of the American Medical Association, 273, 1360–1365.Google Scholar
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). “Mini-Mental State”—A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 12, 189–198.Google Scholar
Heikkila, V.M., Turkka, J., Korpelainen, J., Kallanranta, T., & Summala, H. (1998). Decreased driving ability in people with Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry, 64, 325–330.Google Scholar
Hoehn, M.M. & Yahr, M.D. (1967). Parkinsonism: Onset, progression, and mortality. Neurology, 17, 427–442.Google Scholar
Hughes, C.P, Berg, L., Danziger, W.L., Coben, L.A., & Martin, R.L. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566–572.Google Scholar
Hunt, L.A., Murphy, C.F., Carr, D., Duchek, J.M., Buckles, V., & Morris, J.C. (1997). Reliability of the Washington University Road Test. Archives of Neurology, 54, 707–712.Google Scholar
Madeley, P., Hulley, J.L., Wildgust, H., & Mindham, R.H.S. (1990). Parkinson's disease and driving ability. Journal of Neurology, Neurosurgery & Psychiatry, 53, 580–582.CrossRefGoogle Scholar
Marcotte, T.D., Heaton, R.K., Wolfson, T., Taylor, M.J., Alhassoon, O., Arfaa, K., Grant, I., & the HNRC Group (1999). The impact of HIV-related neuropsychological dysfunction on driving behavior. Journal of the International Neuropsychological Society, 5, 579–592.Google Scholar
Maze Master (Version 1.01) (1992). Computerized Mazes. Boulder, CO: The Flatirons Group.
McKhann, G., Drachman, D., Folstein, M., Price, D., & Stadlan, E. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939–944.Google Scholar
Radford, K.A., Lincoln, N.B., & Lennox, G. (2004). The effects of cognitive abilities on driving in people with Parkinson's disease. Disability Rehabilitation, 26(2), 65–70.Google Scholar
Reger, M.A., Welsh, R.K., Watson, G.S., Cholerton, B., Baker, L.D., & Craft, S. (2004). The relationship between neuropsychological functioning and driving ability in dementia: A meta-analysis. Neuropsychology, 18, 85–93.Google Scholar
Reitan, R.M. & Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery. Tucson, AZ: Neuropsychological Press.
Reitan, R.M. & Wolfson, D. (1993). The Halstead-Reitan Neuropsychological Test Battery: Theory and clinical interpretation, (2nd ed.). South Tucson, AZ: Neuropsychology Press.
Stern, R.A., Javorsky, D.J., Singer, E.A., Harris, N.G., Somerville, J.A., Duke, L.M., Thompson, J.A., & Kaplan, E. (1999). Boston Qualitative Scoring System of the Rey-Osterreith Complex Figure. Odessa, FL: Psychological Assessment Resources.
Stern, R.A. & White, T. (2004). Neuropsychological Assessment Battery (NAB). Lutz, FL: Psychological Assessment Resources.
Tremont, G., Halpert, S., Javorsky, D.J., & Stern, R.A. (2000). Differential impact of executive dysfunction on verbal list learning and story recall. The Clinical Neuropsychologist, 14, 295–302.Google Scholar
Whelihan, W.W., DiCarlo, M.A., & Paul, R.H. (2005). The relationship of neuropsychological functioning to driving competence in older persons with early cognitive decline. Archives of Clinical Neuropsychology, 20, 217–228.Google Scholar
Whithaar, F.K., Brouwer, W.H., & Van Zomeran, A.H. (2000). Fitness to drive in older drivers with cognitive impairment. Journal of the International Neuropsychological Society, 6, 480–490.Google Scholar
Wood, J.M., Warringham, C., Kerr, G., Mallon, K., & Silburn, P. (2005). Quantitative assessment of driving performance in Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry, 76, 176–180.Google Scholar
Zesiewicz, T.A., Cimino, C.R., Malek, A.R., Gardner, N., Leaverton, P.L., Dunne, P.B., & Hauser, R.A. (2002). Driving safety in Parkinson's disease. Neurology, 59, 1787–1788.Google Scholar