title: Mild neuritic changes are increased in the brains of fatally injured older motor vehicle drivers.
abstract: Given the expected increase in the older population and driving in this age group, concerns have been raised about the safety of older drivers. People over 65 years are over-represented in motor vehicle fatalities when calculated by distance driven. They are also at risk of neurodegenerative diseases, such as Alzheimer's disease, that affect cognitive function. We have examined the brains of older drivers (15M:12F) who died as a result of a motor vehicle accident (MVA) to determine the extent of Alzheimer's disease-related neurofibrillary changes (neuritic plaques and neurofibrillary tangles), Lewy body pathology and cerebrovascular disease and compared them to a control group of older licenced drivers (23M:5F) who died of other causes. The prevalence of moderate or severe neuritic plaque pathology was less than expected for the general population of this age and there was no difference between the groups. However, mild neuritic plaque pathology was increased for MVA deaths compared to controls. There was no evidence of vascular dementia or dementia with Lewy bodies. The current mandatory age-related re-licencing procedures in NSW may contribute to the low percentage of drivers with severe pathology. Further research into the role of mild pathology in cognitive impairment and older drivers is warranted.
authors.affiliation: Neural Injury Research Unit, School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia. c.gorrie@unsw.edu.au
authors.forename: C A
authors.initials: CA
authors.lastname: Gorrie
authors.forename: M
authors.initials: M
authors.lastname: Rodriguez
authors.forename: P
authors.initials: P
authors.lastname: Sachdev
authors.forename: J
authors.initials: J
authors.lastname: Duflou
authors.forename: P M E
authors.initials: PM
authors.lastname: Waite
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality*; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000473:pathology; D001315:Australia / Q000453:epidemiology; D001334:Automobile Driving; D001344:Autopsy; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000473:pathology; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D016874:Neurofibrillary Tangles / Q000473:pathology; D058225:Plaque, Amyloid / Q000473:pathology