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Driver route-following and safety errors in early Alzheimer disease

From the Division of Neuroergonomics, Department of Neurology, College of Medicine (Drs. Uc, Rizzo, Anderson, and Dawson, Q. Shi), Department of Mechanical and Industrial Engineering (Dr. Rizzo), Public Policy Center (Dr. Rizzo), and Department of Biostatistics, College of Public Health (Dr. Dawson, Q. Shi), University of Iowa, Iowa City, IA.

Address correspondence and reprint requests to Dr. Matthew Rizzo, Department of Neurology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242; e-mail: matthew-rizzo{at}uiowa.edu

Objective: To assess navigation and safety errors during a route-following task in drivers with Alzheimer disease (AD).

Design/Methods: Thirty-two subjects with probable AD (by National Institute of Neurological and Communicative Disorders criteria) of mild severity and 136 neurologically normal older adults were tested on a battery of visual and cognitive tests of abilities that are critical to safe automobile driving. Each driver also performed a route-finding task administered on the road in an instrumented vehicle. Main outcome variables were number of 1) incorrect turns; 2) times lost; and 3) at-fault safety errors.

Results: The drivers with mild AD made significantly more incorrect turns, got lost more often, and made more at-fault safety errors than control subjects, although their basic vehicular control abilities were normal. The navigational and safety errors were predicted using scores on standardized tests sensitive to visual and cognitive decline in early AD.

Conclusions: Drivers with Alzheimer disease made more errors than neurologically normal drivers on a route-following task that placed demands on driver memory, attention, and perception. The demands of following route directions probably increased the cognitive load during driving, which might explain the higher number of safety errors.

Received August 14, 2003. Accepted in final form May 7, 2004.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the September 14 issue to find the link for this article.

See Commentary, page 765

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September 14 Highlight and Commentary
Neurology 2004 63: 765. [Full Text] [PDF]

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