Neuropsychological domains and fitness to drive in mild cognitive impairment or Alzheimer’s disease

• Published in: Accident analysis and prevention 2023-10, Vol.191, p.107188-107188, Article 107188
• Main Authors: Quintas, Juliana Lima, Trindade, Isabela Oliveira Azevedo, Gameiro, Keli Silva Duarte, Pitta, Leonardo Santos Rocha, Camargos, Einstein Francisco, Nóbrega, Otávio Toledo
• Format: Article
• Language: English
• Subjects: Accidents, Traffic; Aged; Alzheimer disease; Alzheimer Disease - complications; Alzheimer Disease - psychology; Automobile driving; Cognition Disorders; Cognitive dysfunction; Cognitive Dysfunction - complications; Executive Function; Humans; Neuropsychological Tests
• ISSN: 0001-4575; 1879-2057
• DOI: 10.1016/j.aap.2023.107188

•Either mild cognitive impairment (MCI) or Alzheimer’s disease (AD) can impact driving.•Not all impaired cognitive domains lead to poor driving or unfitness to drive.•Our review compiles 20 years of reports associating cognition and driving with MCI/AD.•Executive function losses were the most reported amidst unsafe drivers with MCI/AD.•Decline in attention, processing speed and visuospatial skills were also noteworthy. Cognitive deficits associated with mild cognitive impairment (MCI) or Alzheimer’s disease (AD) can impact driving. This integrative review investigated which cognitive domains were associated with poor driving performance or unfitness to drive in studies with outcomes measured in simulator or on-road driving in patients with MCI or AD. The review was conducted by searching for articles published between 2001 and 2020 in the MEDLINE (via PubMed), EMBASE, and SCOPUS databases. Studies addressing patients with other dementias (e.g., vascular or mixed dementia, Lewy body dementia, Parkinson’s disease) were excluded. Of 404 articles initially selected, 17 met the eligibility criteria for this review. Based on the findings of this integrative review, attentional capacity, processing speed, executive functions and visuospatial skills were the functions whose declines were most frequently reported in a context of unsafe driving by older adults with MCI or AD. Reports were remarkably heterogeneous in methodological aspects whereas quite limited in cross-cultural coverage and in sample recruited, what prompts for further trials in the field.