Psychiatry investigation

Korean Neuropsychiatric Association (대한신경정신의학회)
권호 표지
DOI QR코드

DOI QR Code

Subcortical Ischemic Change as a Predictor of Driving Cessation in the Elderly

  • Jang, Mi (Department of General Psychiatry, National Center for Mental Health) ;
  • Hong, Chang Hyung (Department of Psychiatry, Ajou University School of Medicine) ;
  • Kim, Hyun-Chung (Department of Psychiatry, National Medical Center of Korea) ;
  • Choi, Seong Hye (Department of Neurology, Inha University College of Medicine) ;
  • Seo, Sang Won (Department of Neurology, Samsung Medical Center) ;
  • Kim, Seong Yoon (Department of Psychiatry, Asan Medical Center) ;
  • Na, Duk L. (Department of Neurology, Samsung Medical Center) ;
  • Lee, Yunhwan (Department of Preventive Medicine and Public Health, Ajou University School of Medicine) ;
  • Chang, Ki Jung (Department of Psychiatry, Ajou Good Hospital) ;
  • Roh, Hyun Woong (Department of Brain Science, Ajou University School of Medicine) ;
  • Son, Sang Joon (Department of Psychiatry, Ajou University School of Medicine)
  • Received : 2018.07.16
  • Accepted : 2018.10.10
  • Published : 2018.12.31
⟨ Previous Next ⟩

Abstract

Objective Motor, perceptual, and cognitive functions are known to affect driving competence. Subcortical ischemic changes on brain magnetic resonance imaging (MRI) can reflect reduction in cognitive and motor performance. However, few studies have reported the relationship between subcortical ischemic changes and driving competence of the elderly. Thus, the objective of this study was to investigate the association between subcortical ischemic changes on MRI and driving abilities of the elderly. Methods Participants (n=540) were drawn from a nationwide, multicenter, hospital-based, longitudinal cohort. Each participant underwent MRI scan and interview for driving capacity categorized into 'now driving' and 'driving cessation (driven before, not driving now)'. Participants were divided into three groups (mild, n=389; moderate, n=116; and severe, n=35) depending on the degree of white matter hyperintensity (WMH) on MRI at baseline. Driving status was evaluated at follow-up. Statistical analyses were conducted using ${\chi}^2$ test, analysis of variance (ANOVA), structured equation model (SEM), and generalized estimating equation (GEE). Results In SEM, greater baseline degree of WMH was directly associated with driving cessation regardless of cognitive or motor dysfunction (${\beta}=-0.110$, p<0.001). In GEE models after controlling for age, sex, education, cognitive, and motor dysfunction, more severe change in the degree of WMH was associated with faster change from 'now driving' state to 'driving cessation' state over time in the elderly (${\beta}=-0.508$, p<0.001). Conclusion In both cross-sectional and longitudinal results, the degree of subcortical ischemic change on MRI might predict driving cessation in the elderly.

Keywords

Acknowledgement

Supported by : Ministry of Health & Welfare

References

  1. Sherman FT. Driving: the ultimate IADL. Geriatrics 2006;61:9-10.
  2. De Raedt R, Ponjaert-Kristoffersen I. Predicting at-fault car accidents of older drivers. Accid Anal Prev 2001;33:809-819. https://doi.org/10.1016/S0001-4575(00)00095-6
  3. Marottoli RA, Cooney LM Jr, Wagner R, Doucette J, Tinetti ME. Predictors of automobile crashes and moving violations among elderly drivers. Ann Intern Med 1994;121:842-846. https://doi.org/10.7326/0003-4819-121-11-199412010-00003
  4. Hiscock R, Macintyre S, Kearns A, Ellaway A. Means of transport and ontological security: do cars provide psycho-social benefits to their users? Transp Res D Transp Environ 2002;7:119-135. https://doi.org/10.1016/S1361-9209(01)00015-3
  5. Marottoli RA, Mendes de Leon CF, Glass TA, Williams CS, Cooney LM Jr, Berkman LF, et al. Driving cessation and increased depressive symptoms: prospective evidence from the New Haven EPESE. Established Populations for Epidemiologic Studies of the Elderly. J Am Geriatr Soc 1997;45:202-206. https://doi.org/10.1111/j.1532-5415.1997.tb04508.x
  6. Taylor BD, Tripodes S. The effects of driving cessation on the elderly with dementia and their caregivers. Accid Anal Prev 2001;33:519-528. https://doi.org/10.1016/S0001-4575(00)00065-8
  7. Wagner JT, Muri RM, Nef T, Mosimann UP. Cognition and driving in older persons. Swiss Med Wkly 2011;140:w13136.
  8. Ryan GA, Legge M, Rosman D. Age related changes in drivers' crash risk and crash type. Accid Anal Prev 1998;30:379-387. https://doi.org/10.1016/S0001-4575(97)00098-5
  9. Man-Son-Hing M, Marshall SC, Molnar FJ, Wilson KG. Systematic review of driving risk and the efficacy of compensatory strategies in persons with dementia. J Am Geriatr Soc 2007;55:878-884. https://doi.org/10.1111/j.1532-5415.2007.01177.x
  10. Dawson JD, Anderson SW, Uc EY, Dastrup E, Rizzo M. Predictors of driving safety in early Alzheimer disease. Neurology 2009;72:521-527. https://doi.org/10.1212/01.wnl.0000341931.35870.49
  11. Crizzle AM, Classen S, Uc EY. Parkinson disease and driving: an evidence-based review. Neurology 2012;79:2067-2074. https://doi.org/10.1212/WNL.0b013e3182749e95
  12. Gorelick PB, Scuteri A, Black SE, Decarli C, Greenberg SM, Iadecola C, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the american heart association/american stroke association. Stroke 2011;42:2672-2713. https://doi.org/10.1161/STR.0b013e3182299496
  13. Debette S, Markus HS. The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 2010;341:c3666. https://doi.org/10.1136/bmj.c3666
  14. Silbert LC, Nelson C, Howieson DB, Moore MM, Kaye JA. Impact of white matter hyperintensity volume progression on rate of cognitive and motor decline. Neurology 2008;71:108-113. https://doi.org/10.1212/01.wnl.0000316799.86917.37
  15. Pantoni L, Basile AM, Pracucci G, Asplund K, Bogousslavsky J, Chabriat H, et al. Impact of age-related cerebral white matter changes on the transition to disability-the LADIS study: rationale, design and methodology. Neuroepidemiology 2005;24:51-62. https://doi.org/10.1159/000081050
  16. Scheltens P, Barkhof F, Leys D, Pruvo JP, Nauta JJ, Vermersch P, et al. A semiquantative rating scale for the assessment of signal hyperintensities on magnetic resonance imaging. J Neurol Sci 1993;114:7-12. https://doi.org/10.1016/0022-510X(93)90041-V
  17. Son SJ, Lee KS, Lee Y, Baek JH, Choi SH, Na DL, et al. Association between white matter hyperintensity severity and cognitive impairment according to the presence of the apolipoprotein E (APOE) ${\varepsilon}4$ allele in the elderly: retrospective analysis of data from the CREDOS study. J Clin Psychiatry 2012;73:1555-1562. https://doi.org/10.4088/JCP.12m07702
  18. Kang Y ND, Hahn S. A validity study on the Korean mini-mental state examination (K-MMSE) in dementia patients. J Korean Neurol Assoc 1997:300-308.
  19. Morris JC. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 1993;43:2412-2414.
  20. Mahoney FI, Barthel DW. Functional evaluation: the barthel index. Md State Med J 1965;14:61-65.
  21. Ku HM KJ, Kwon EJ, Kim SH, Lee HS, Ko HJ, Jo S, Kim DK. A study on the reliability and validity of Seoul-Instrumental Activities of Daily Living (S-IADL). J Korean Neuropsychiatr Assoc 2004: 189-199.
  22. Kang Y, Na DL. Seoul Neuropsychological Screening Battery (SNSB). Seoul: Human Brain Research & Consulting Co; 2003.
  23. Kim H, Na DL. Normative data on the Korean version of the Boston Naming Test. J Clin Exp Neuropsychol 1999;21:127-133. https://doi.org/10.1076/jcen.21.1.127.942
  24. Olsen K, Taylor JP, Thomas A. Mild cognitive impairment: safe to drive? Maturitas 2014;78:82-85. https://doi.org/10.1016/j.maturitas.2014.03.004
  25. Vaughan L, Hogan PE, Rapp SR, Dugan E, Marottoli RA, Snively BM, et al. Driving with Mild Cognitive Impairment or Dementia: Cognitive Test Performance and Proxy Report of Daily Life Function in Older Women. J Am Geriatr Soc 2015;63:1774-1782. https://doi.org/10.1111/jgs.13634
  26. Mathias JL, Lucas LK. Cognitive predictors of unsafe driving in older drivers: a meta-analysis. Int Psychogeriatr 2009;21:637-653. https://doi.org/10.1017/S1041610209009119
  27. Adler G, Rottunda S, Dysken M. The older driver with dementia: an updated literature review. J Safety Res 2005;36:399-407. https://doi.org/10.1016/j.jsr.2005.07.005
  28. Silva MT, Laks J, Engelhardt E. Neuropsychological tests and driving in dementia: a review of the recent literature. Rev Assoc Med Bras (1992) 2009;55:484-488. https://doi.org/10.1590/S0104-42302009000400027
  29. Brown LB, Ott BR. Driving and dementia: a review of the literature. J Geriatr Psychiatry Neurol 2004;17:232-240. https://doi.org/10.1177/0891988704269825
  30. Brown LB, Stern RA, Cahn-Weiner DA, Rogers B, Messer MA, Lannon MC, et al. Driving scenes test of the Neuropsychological Assessment Battery (NAB) and on-road driving performance in aging and very mild dementia. Arch Clin Neuropsychol 2005;20:209-215. https://doi.org/10.1016/j.acn.2004.06.003
  31. Ott BR, Anthony D, Papandonatos GD, D'Abreu A, Burock J, Curtin A, et al. Clinician assessment of the driving competence of patients with dementia. J Am Geriatr Soc 2005;53:829-833. https://doi.org/10.1111/j.1532-5415.2005.53265.x
  32. Szlyk JP, Myers L, Zhang Y, Wetzel L, Shapiro R. Development and assessment of a neuropsychological battery to aid in predicting driving performance. J Rehabil Res Dev 2002;39:483-496.
  33. Reger MA, Welsh RK, Watson GS, Cholerton B, Baker LD, Craft S. The relationship between neuropsychological functioning and driving ability in dementia: a meta-analysis. Neuropsychology 2004;18:85-93. https://doi.org/10.1037/0894-4105.18.1.85
  34. Ott BR, Heindel WC, Papandonatos GD, Festa EK, Davis JD, Daiello LA, et al. A longitudinal study of drivers with Alzheimer disease. Neurology 2008;70:1171-1178. https://doi.org/10.1212/01.wnl.0000294469.27156.30
  35. Duchek JM, Carr DB, Hunt L, Roe CM, Xiong C, Shah K, et al. Longitudinal driving performance in early-stage dementia of the Alzheimer type. J Am Geriatr Soc 2003;51:1342-1347. https://doi.org/10.1046/j.1532-5415.2003.51481.x
  36. Iverson DJ, Gronseth GS, Reger MA, Classen S, Dubinsky RM, Rizzo M, et al. Practice parameter update: evaluation and management of driving risk in dementia: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2010;74:1316-1324. https://doi.org/10.1212/WNL.0b013e3181da3b0f
  37. Uc EY, Rizzo M, Anderson SW, Sparks JD, Rodnitzky RL, Dawson JD. Driving with distraction in Parkinson disease. Neurology 2006;67:1774-1780. https://doi.org/10.1212/01.wnl.0000245086.32787.61
  38. Uc EY, Rizzo M, Johnson AM, Dastrup E, Anderson SW, Dawson JD. Road safety in drivers with Parkinson disease. Neurology 2009;73:2112-2119. https://doi.org/10.1212/WNL.0b013e3181c67b77
  39. Alexander NB. Postural control in older adults. J Am Geriatr Soc 1994;2:93-108.
  40. Koo BB, Bergethon P, Qiu WQ, Scott T, Hussain M, Rosenberg I, et al. Clinical prediction of fall risk and white matter abnormalities: a diffusion tensor imaging study. Arch Neurol 2012;69:733-738.
  41. Moscufo N, Guttmann CR, Meier D, Csapo I, Hildenbrand PG, Healy BC, et al. Brain regional lesion burden and impaired mobility in the elderly. Neurobiol Aging 2011;32:646-654. https://doi.org/10.1016/j.neurobiolaging.2009.04.010
  42. Srikanth V, Phan TG, Chen J, Beare R, Stapleton JM, Reutens DC. The location of white matter lesions and gait--a voxel-based study. Ann Neurol 2010;67:265-269. https://doi.org/10.1002/ana.21826
  43. Whitman GT, Tang Y, Lin A, Baloh RW. A prospective study of cerebral white matter abnormalities in older people with gait dysfunction. Neurology 2001;57:990-994. https://doi.org/10.1212/WNL.57.6.990
  44. Wolfson L, Wei X, Hall CB, Panzer V, Wakefield D, Benson RR, et al. Accrual of MRI white matter abnormalities in elderly with normal and impaired mobility. J Neurol Sci 2005;232:23-27. https://doi.org/10.1016/j.jns.2004.12.017
  45. Starr JM, Leaper SA, Murray AD, Lemmon HA, Staff RT, Deary IJ, et al. Brain white matter lesions detected by magnetic resonance [correction of resosnance] imaging are associated with balance and gait speed. J Neurol Neurosurg Psychiatry 2003;74:94-98. https://doi.org/10.1136/jnnp.74.1.94
  46. Willey JZ, Scarmeas N, Provenzano FA, Luchsinger JA, Mayeux R, Brickman AM. White matter hyperintensity volume and impaired mobility among older adults. J Neurol 2013;260:884-890. https://doi.org/10.1007/s00415-012-6731-z
  47. Inzitari D, Simoni M, Pracucci G, Poggesi A, Basile AM, Chabriat H, et al. Risk of rapid global functional decline in elderly patients with severe cerebral age-related white matter changes: the LADIS study. Arch Intern Med 2007;167:81-88. https://doi.org/10.1001/archinte.167.1.81
  48. Baezner H, Blahak C, Poggesi A, Pantoni L, Inzitari D, Chabriat H, et al. Association of gait and balance disorders with age-related white matter changes: the LADIS study. Neurology 2008;70:935-942. https://doi.org/10.1212/01.wnl.0000305959.46197.e6
  49. Pohjasvaara TI, Jokinen H, Ylikoski R, Kalska H, Mantyla R, Kaste M, et al. White matter lesions are related to impaired instrumental activities of daily living poststroke. J Stroke Cerebrovasc Dis 2007;16:251-258. https://doi.org/10.1016/j.jstrokecerebrovasdis.2007.08.001
  50. Ylikoski R, Ylikoski A, Erkinjuntti T, Sulkava R, Raininko R, Tilvis R. White matter changes in healthy elderly persons correlate with attention and speed of mental processing. Arch Neurol 1993;50:818-824. https://doi.org/10.1001/archneur.1993.00540080029009
  51. Moon SY, Na DL, Seo SW, Lee JY, Ku BD, Kim SY, et al. Impact of white matter changes on activities of daily living in mild to moderate dementia. Eur Neurol 2011;65:223-230. https://doi.org/10.1159/000318161
  52. Gouw AA, Van der Flier WM, van Straaten EC, Barkhof F, Ferro JM, Baezner H, et al. Simple versus complex assessment of white matter hyperintensities in relation to physical performance and cognition: the LADIS study. J Neurol 2006;253:1189-1196. https://doi.org/10.1007/s00415-006-0193-5
  53. Pantoni L, Poggesi A, Basile AM, Pracucci G, Barkhof F, Chabriat H, et al. Leukoaraiosis predicts hidden global functioning impairment in nondisabled older people: the LADIS (Leukoaraiosis and Disability in the Elderly) Study. J Am Geriatr Soc 2006;54:1095-1101. https://doi.org/10.1111/j.1532-5415.2006.00798.x
  54. Ye BS, Seo SW, Kim GH, Noh Y, Cho H, Yoon CW, et al. Amyloid burden, cerebrovascular disease, brain atrophy, and cognition in cognitively impaired patients. Alzheimers Dement 2015;11:494-503. e493. https://doi.org/10.1016/j.jalz.2014.04.521
  55. Fazekas F, Ropele S, Schmidt R. Can small-vessel disease-related cerebral abnormalities be used as a surrogate marker for vascular dementia trials? J Neural Transm Suppl 2002;(62):61-67.

Cited by

  1. Regional Gray Matter Volume Identifies High Risk of Unsafe Driving in Healthy Older People vol.12, pp.None, 2020, https://doi.org/10.3389/fnagi.2020.592979
  2. The influence of spouses and their driving roles in self-regulation: A qualitative exploration of driving reduction and cessation practices amongst married older adults vol.15, pp.5, 2020, https://doi.org/10.1371/journal.pone.0232795