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. 2017 Jan;3(1):74-82.
doi: 10.1016/j.trci.2016.11.006.

Preclinical Alzheimer's disease and longitudinal driving decline

Catherine M Roe  1   2 , Ganesh M Babulal  1   2 , Denise M Head  1   3 , Sarah H Stout  1   2 , Elizabeth K Vernon  1   2 , Nupur Ghoshal  1   2 , Brad Garland  4 , Peggy P Barco  5   6 , Monique M Williams  7 , Ann Johnson  8 , Rebecca Fierberg  1   2 , M Scot Fague  1   9 , Chengjie Xiong  1   9 , Elizabeth Mormino  10 , Elizabeth A Grant  1   9 , David M Holtzman  1   2 , Tammie L S Benzinger  1   11   12 , Anne M Fagan  1   2 , Brian R Ott  13 , David B Carr  8   6 , John C Morris  1   2   5   14   15
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Preclinical Alzheimer's disease and longitudinal driving decline

Catherine M Roe et al. Alzheimers Dement (N Y). 2017 Jan.

Abstract

Introduction: Links between preclinical 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: 104 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 CSF tau/Aβ42 and ptau181/Aβ42 ratios, but not uptake on PIB 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.

Keywords: Alzheimer disease; aged; amyloid imaging; biomarker; cerebrospinal fluid; driving; functional outcome; older adults; preclinical; ptau; road test; tau.

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Conflict of interest statement

Declaration of interest Dr. Roe reports no conflicts of interest. Dr. Babulal reports no conflicts of interest. Dr. Head reports no conflicts of interest. Ms. Stout reports no conflicts of interest. Ms. Vernon reports no conflicts of interest. Dr. Ghoshal reports no conflicts of interest. Mr. Garland reports no conflicts of interest. Dr. Barco reports no conflicts of interest. Dr. Williams reports no conflicts of interest. Ms. Johnson reports no conflicts of interest. Ms. Fierberg reports no conflicts of interest. Mr. Fague reports no conflicts of interest. Dr. Xiong reports no conflicts of interest. Dr. Mormino reports no conflicts of interest. Dr. Grant reports no conflicts of interest. Dr. Holtzman reports no conflicts of interest. Dr. Holtzman reports no conflicts of interest. Dr. Fagan reports no conflicts of interest. Dr. Ott reports no conflicts of interest. Dr. Carr reports no conflicts of interest. Dr. Morris reports no conflicts of interest.

Figures

Fig. 1
Fig. 1
Kaplan-Meier curves. Kaplan-Meier curves showing relationships between biomarkers and time to a rating of marginal or fail on the road test (A–C) and change in some of the cognitive outcomes as a function of baseline CSF tau/Aβ42 values (D–F). Dotted lines = lower biomarker values, solid lines = higher biomarker values. Abbreviations: CDR, clinical dementia rating; CSF, cerebrospinal fluid; MCBP, mean cortical binding potential; PIB, Pittsburgh compound B.
See this image and copyright information in PMC

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