Anxiety of Alzheimer's disease patients before and after a standardized on-road driving test.
BACKGROUND
A large number of licensed elderly drivers are demented or are likely to become demented. On-road driving tests, a method often used to assess driver competency, are likely anxiety-provoking for elderly individuals. This article examines the relationship between anxiety and driving performance in a mildly demented and elderly control (EC) sample.


METHODS
Anxiety ratings of fear and tension, as assessed by visual analog scales, of 84 patients clinically diagnosed with mild Alzheimer's disease (AD) (68 safe/marginal and 16 unsafe drivers) were compared with those of 44 age- and education-equated safe/marginal EC participants, both before and after a standardized on-road driving test.


RESULTS
Analyses revealed significant positive correlations between AD patients' pre-road test and post-road test tension and post-road test fear ratings and total road test score. Subsequent analyses of variance showed no significant pre-road test differences in fear ratings between the three groups but significantly higher levels of tension among the unsafe AD participants. After adjusting for baseline group differences, unsafe AD drivers experienced stable or higher anxiety levels after road test, whereas both the EC and safe/marginal AD drivers endorsed a significant reduction in anxiety.


CONCLUSIONS
Unlike their safe EC and safe AD driver counterparts, unsafe AD patients reported continued elevated levels of fear and tension after the road test. Given these findings, we suggest that the most appropriate time for driving instructors to counsel patients regarding their driving skills might be directly after the road test.
Bhalla
Rishi K
RK
Department of Clinical Neurosciences, Brown University, Providence, RI, USA. bhallark@upmc.edu
Papandonatos
George D
GD
Stern
Robert A
RA
Ott
Brian R
BR