Using the A/T/N Framework to Examine Driving in Preclinical AD

Catherine M Roe; Ganesh M Babulal; Sarah H Stout; Brian R Ott; David B Carr; Monique M Williams; Tammie L S Benzinger; Anne M Fagan; David M Holtzman; Beau M Ances; John C Morris

doi:10.3390/geriatrics3020023

Using the A/T/N Framework to Examine Driving in Preclinical AD

Geriatrics (Basel). 2018 Jun;3(2):23. doi: 10.3390/geriatrics3020023. Epub 2018 May 2.

Authors

Catherine M Roe^{1

2}, Ganesh M Babulal^{1

2}, Sarah H Stout^{1

2}, Brian R Ott³, David B Carr⁴, Monique M Williams⁵, Tammie L S Benzinger^{1

6

7}, Anne M Fagan^{1

2

8}, David M Holtzman^{1

2

8}, Beau M Ances^{1

2}, John C Morris^{1

2

7

9

10

11}

Affiliations

¹ Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO.
² Department of Neurology, Washington University School of Medicine, St. Louis, MO.
³ The Alzheimer's Disease & Memory Disorders Center, Alpert Medical School of Brown University, St. Louis, MO.
⁴ Department of Medicine, Washington University School of Medicine, St. Louis, MO.
⁵ VITAS Healthcare, St. Louis, MO.
⁶ Department of Radiology, Washington University School of Medicine, St. Louis, MO.
⁷ Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO.
⁸ The Hope Center for Neurological Disorders; Washington University School of Medicine, St. Louis, MO.
⁹ Department of Occupational Therapy, Washington University School of Medicine, St. Louis, MO.
¹⁰ Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO.
¹¹ Department of Physical Therapy, Washington University School of Medicine, St. Louis, MO.

Abstract

The A/T/N classification system is the foundation of the 2018 NIA-AA Research Framework and is intended to guide the Alzheimer disease (AD) research agenda for the next 5–10 years. Driving is a widespread functional activity that may be particularly useful in investigation of functional changes in pathological AD before onset of cognitive symptoms. We examined driving in preclinical AD using the A/T/N framework and found that the onset of driving difficulties is most associated with abnormality of both amyloid and tau pathology, rather than amyloid alone. These results have implications for participant selection into clinical trials and for the application time of interventions aimed at prolonging the time of safe driving among older adults with preclinical AD.

Keywords: biomarkers; driving; preclinical Alzheimer disease.

Abstract

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