Alterations in driving ability and their relationship with morphometric magnetic resonance imaging indicators in patients with amnestic mild cognitive impairment and Alzheimer's disease

Hideaki Wakita; Yu Takahashi; Satoshi Masuzugawa; Hiroyuki Miyasaka; Shigeru Sonoda; Akihiro Shindo; Hidekazu Tomimoto

doi:10.1111/psyg.13128

Alterations in driving ability and their relationship with morphometric magnetic resonance imaging indicators in patients with amnestic mild cognitive impairment and Alzheimer's disease

Psychogeriatrics. 2024 May 1. doi: 10.1111/psyg.13128. Online ahead of print.

Authors

Hideaki Wakita^{1

2}, Yu Takahashi^{1

2}, Satoshi Masuzugawa³, Hiroyuki Miyasaka⁴, Shigeru Sonoda⁵, Akihiro Shindo², Hidekazu Tomimoto^{2

6}

Affiliations

¹ Department of Internal Medicine, Nanakuri Memorial Hospital, Fujita Health University, Tsu, Japan.
² Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan.
³ Masuzugawa Neurology Clinic, Suzuka, Japan.
⁴ Department of Rehabilitation, Fujita Health University Nanakuri Memorial Hospital, Tsu, Japan.
⁵ Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
⁶ Saiseikai Meiwa Hospital, Meiwa, Japan.

PMID: 38692585
DOI: 10.1111/psyg.13128

Abstract

Background: Drivers with dementia are at a higher risk of motor vehicle accidents. The characteristics of driving behaviour of patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) have not been fully elucidated. We investigated driving ability and its relationship with cognitive function and magnetic resonance imaging (MRI) morphometry indicators.

Methods: The driving abilities of 19 patients with AD and 11 with amnestic MCI (aMCI) were evaluated using a driving simulator. The association between each driving ability parameter and the Mini-Mental State Examination (MMSE) score or voxel-based specific regional analysis system for AD (VSRAD) was assessed.

Results: Patients with AD made a significantly higher number of operational errors than those with aMCI in attention allocation in the complex task test (P = 0.0008). The number of operational errors in attention allocation in the complex task test significantly and negatively correlated with MMSE scores in all participants (r = -0.4354, P = 0.0162). The decision time in the selective reaction test significantly and positively correlated with the severity and extent of medial temporal structural atrophy (r = 0.4807, P = 0.0372; r = 0.4862, P = 0.0348; respectively).

Conclusion: An increase in the operational errors for attention allocation in the complex task test could be a potential indicator of progression from aMCI to AD. Atrophy of the medial temporal structures could be a potential predictor of impaired judgement in driving performance in aMCI and AD. A driving simulator could be useful for evaluating the driving abilities of individuals with aMCI and AD.

Keywords: Alzheimer's disease; driving ability; magnetic resonance imaging; mild cognitive impairment; simulator.