Brain amyloid in preclinical Alzheimer's disease is associated with increased driving risk

Brian R Ott; Richard N Jones; Richard B Noto; Don C Yoo; Peter J Snyder; Justine N Bernier; David B Carr; Catherine M Roe

doi:10.1016/j.dadm.2016.10.008

Brain amyloid in preclinical Alzheimer's disease is associated with increased driving risk

Alzheimers Dement (Amst). 2016 Nov 29:6:136-142. doi: 10.1016/j.dadm.2016.10.008. eCollection 2017.

Authors

Brian R Ott¹, Richard N Jones², Richard B Noto³, Don C Yoo³, Peter J Snyder¹, Justine N Bernier⁴, David B Carr⁵, Catherine M Roe⁶

Affiliations

¹ Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA; Department of Neurology, Rhode Island Hospital, Providence, RI, USA.
² Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA; Department of Neurology, Rhode Island Hospital, Providence, RI, USA; Department of Psychiatry and Human Behavior, Rhode Island Hospital, Providence, RI, USA.
³ Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA; Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA.
⁴ Department of Neurology, Rhode Island Hospital, Providence, RI, USA.
⁵ Department of Neurology, Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO, USA; Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
⁶ Department of Neurology, Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Department of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO, USA.

Abstract

Introduction: Postmortem studies suggest that fibrillar brain amyloid places people at higher risk for hazardous driving in the preclinical stage of Alzheimer's disease (AD).

Methods: We administered driving questionnaires to 104 older drivers (19 AD, 24 mild cognitive impairment, and 61 cognitive normal) who had a recent ¹⁸F-florbetapir positron emission tomography scan. We examined associations of amyloid standardized uptake value ratios with driving behaviors: traffic violations or accidents in the past 3 years.

Results: The frequency of violations or accidents was curvilinear with respect to standardized uptake value ratios, peaking around a value of 1.1 (model r² = 0.10, P = .002); moreover, this relationship was evident for the cognitively normal participants.

Discussion: We found that driving risk is strongly related to accumulating amyloid on positron emission tomography, and that this trend is evident in the preclinical stage of AD. Brain amyloid burden may in part explain the increased crash risk reported in older adults.

Keywords: Alzheimer's disease; Assessment of cognitive disorders; Biomarkers; Cognitive aging; Dementia; Driving; MCI (mild cognitive impairment).

Grants and funding

R03 AG046472/AG/NIA NIH HHS/United States