The impact of HIV-related neuropsychological dysfunction on driving behavior. The HNRC Group.
HIV infection often results in neuropsychological (NP) impairment. In order to assess the impact that HIV-related NP deficits may have on automobile driving, we evaluated 68 HIV-seropositive drivers using an NP battery and two PC-based driving simulations. Thirty-two participants were classified as NP impaired; most (72%) evidenced only mild impairment, and none met criteria for HIV-associated dementia. After controlling for degree of immunosuppression and disease stage, NP-impaired participants failed a previously validated driving simulation at a much higher rate than cognitively intact participants [OR = 5.3, 95% CI (1.7, 17.0), p = .006]. Similarly, on a simulation of city driving, NP impaired participants were more likely to fail based upon the number of accidents [OR = 6.1, 95% CI (1.5, 24.6), p = .01]. Simulator performance was predicted by functioning in a number of NP domains, with NP tests accounting for 13-30% of the variance on the simulations. Although it would be premature to extrapolate these findings to impairment in on-the-road driving, they do argue for greater attention to the impact that even mild HIV-related NP deficits may have on driving skills.
Marcotte
T D
TD
University of California at San Diego, Department of Psychiatry, USA. tmarcotte@ucsd.edu
Heaton
R K
RK
Wolfson
T
T
Taylor
M J
MJ
Alhassoon
O
O
Arfaa
K
K
Ellis
R J
RJ
Grant
I
I
D015526:AIDS Dementia Complex / Q000150:complications*; D000328:Adult; D001334:Automobile Driving / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index