Prediction of on-road driving performance in patients with early Alzheimer's disease.
OBJECTIVE
Physicians and family members frequently are asked to provide information about driving ability in patients with Alzheimer's disease (AD), yet there has been little research on the validity of their assessments of driving performance.


METHODS
Cross-sectional.


METHODS
Participants were recruited from the neurology department of a community hospital affiliated with Brown Medical School.


METHODS
Participants included 75 older adults (17 with mild AD, 33 with very mild AD, and 25 elderly controls).


METHODS
The participant him/herself, an informant, and an experienced neurologist rated each participant's driving ability on a 3-point rating scale (safe, marginal, unsafe). A professional driving instructor also completed a standardized 108-point on-road driving assessment of each participant and then rated driving ability on the 3-point scale. Ratings were compared with the on-road driving score and with each other.


RESULTS
Only the neurologist's rating of the participants' driving abilities was significantly related to on-road driving score. When related to the instructor's safety rating, the neurologist's ratings were the most sensitive and specific. Mini-Mental State Examination score was a borderline covariate for the neurologist's rating. Overall, the instructor was the most stringent rater of participant driving ability, followed by the neurologist, the informant, and the participant.


CONCLUSIONS
An experienced neurologist's assessment of driving competence may be a valid predictor of driving performance of patients with early AD.
Brown
Laura B
LB
Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, USA. Laura_B_Brown@Brown.edu <Laura_B_Brown@Brown.edu>
Ott
Brian R
BR
Papandonatos
George D
GD
Sui
Yunxia
Y
Ready
Rebecca E
RE
Morris
John C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D000544:Alzheimer Disease / Q000150:complications* / Q000523:psychology*; D001334:Automobile Driving; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009460:Neurologic Examination; D015588:Observer Variation; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013647:Task Performance and Analysis