Key Factors Influencing Driving Cessation in Cognitively Normal Elderly
With the aging population and the rise in Alzheimer’s disease (AD) cases, it's crucial to understand why some older adults stop driving. Driving is vital for independence, but its cessation is a significant concern, especially in the context of normal aging and preclinical AD. This study examined 283 older adults (aged 65+), all cognitively normal, from the Knight Alzheimer Disease Research Center and The DRIVES Project. They underwent annual clinical, neurological, and neuropsychological assessments, including PET imaging and CSF biomarker analysis.
Over an average follow-up of 5.62 years, 8% of participants ceased driving. Key factors linked to driving cessation were older age, female sex, progression to symptomatic AD, and lower scores on the Preclinical Alzheimer Cognitive Composite (PACC). While PET imaging did not predict driving cessation, certain CSF biomarkers (t-Tau/Aβ42 and p-Tau/Aβ42 ratios) were significant predictors when adjusted for age, education, and sex. However, in a comprehensive model, clinical measures like the Clinical Dementia Rating (CDR) and PACC score were more strongly associated with driving cessation than AD biomarkers.
The findings suggest that clinical and neuropsychological assessments are crucial in predicting driving cessation. This emphasizes the importance of early discussions and planning around driving retirement as cognitive decline progresses. The study highlights the need for clinicians to consider these factors to help maintain the safety and independence of older adults.
