Depression and Alzheimer’s Disease Biomarkers Predict Driving Decline

Babulal, Ganesh M.; Chen, Suziek; Williams, Monique M.; Trani, Jean-Francois; Bakhshi, Parul; Chao, Grace L.; Stout, Sarah H.; Fagan, Anne M.; Benzinger, Tammie L.S.; Holtzman, David M.; Morris, John C.; Roe, Catherine M.. Journal of Alzheimer’s Disease, Volume 66, Issue 3, 2018, Pages 1213-1221 Read More

Abstract

Background: Symptomatic Alzheimer’s disease (AD) and depression independently increase crash risk. Additionally, depression is both a risk factor for and a consequence of AD. Objective: To examine whether a depression diagnosis, antidepressant use, and preclinical AD are associated with driving decline among cognitively normal older adults. Methods: Cognitively normal participants, age ≥65, were enrolled. Cox proportional hazards models evaluated whether a depression diagnosis, depressive symptoms (Geriatric Depression Scale), antidepressant use, cerebrospinal fluid (amyloid-β 42 [Aβ 42 ], tau, phosphorylated tau 181 [ptau 181 ]), and amyloid imaging biomarkers (Pittsburgh Compound B and Florbetapir) were associated with time to receiving a rating of marginal/fail on a road test. Age was adjusted for in all models. Results: Data were available from 131 participants with age ranging from 65.4 to 88.2 years and mean follow up of 2.4 years (SD = 1.0). A depression diagnosis was associated with a faster time to receiving a marginal/fail rating on a road test and antidepressant use (p = 0.024, HR = 2.62). Depression diagnosis and CSF and amyloid PET imaging biomarkers were associated with driving performance on the road test (p≤0.05, HR = 2.51-3.15). In the CSF ptau 181 model, depression diagnosis (p = 0.031, HR = 2.51) and antidepressant use (p = 0.037, HR = 2.50) were statistically significant predictors. There were no interaction effects between depression diagnosis, antidepressant use, and biomarker groups. Depressive symptomology was not a statistically significant predictor of driving performance. Conclusions: While, as previously shown, preclinical AD alone predicts a faster time to receiving a marginal/fail rating, these results suggest that also having a diagnosis of depression accelerates the onset of driving problems in cognitively normal older adults. © 2018-IOS Press and the authors. All rights reserved.

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Posted on December 6, 2018
Posted in: Clocks & Sleep, HPAN, Neurodegeneration, Publications Authors: , ,