All ETDs from UAB

Advisory Committee Chair

Virginia G Wadley

Advisory Committee Members

Michael Crowe

Amy Knight

Richard Kennedy

Cynthia Owsley

Document Type

Thesis

Date of Award

2018

Degree Name by School

Master of Arts (MA) College of Arts and Sciences

Abstract

Driving is an important instrumental activity of daily living (IADL) that is crucial for mobility and independence of adults in the United States. Dementia and cognitive impairment are indicated as increasing risk for driving impairment and cessation, prompting the necessity for screeners in predicting impaired driving performance. The Trails Making Test (TMT) A and B, and the Useful Field of View (UFOV) are common measures used to predict driving performance across populations of older adults. Prior research has shown that Mild Cognitive Impairment (MCI), which is theorized as an intermediary between normal aging and dementia, is associated with subtle declines in driving performance; however, recent research involving driving simulators has suggested that individuals with amnestic MCI multiple domain (aMCI-md) may have an increased risk for driving impairment compared to those with amnestic MCI single domain (aMCI-sd). The present study is the first to examine differences in driving performance of amnestic MCI subtypes evaluated by an on-road driving assessment. In addition, the present study is the first to examine the Receiver Operating Characteristic (ROC) curves of the TMT-A, TMT-B, and UFOV divided attention (UFOV-2) to determine potential cut points for the respective measures within an MCI population. Ninety-eight participants on a continuum of MCI underwent an on-road driving evaluation administered by a Certified Driving Rehabilitation Specialist (CDRS) and a back seat rater. Results indicated that those with aMCI-md performed significantly worse on global driving ratings than those with aMCI-sd, even after adjusting for age, education, and visual acuity. Examination of ROC curves confirm the predictive utility of Trails A, Trails B, and UFOV divided attention in predicting on-road driving performance in older adults, and expand these findings to an MCI population. The suggested cut-offs for predicting unsatisfactory driving performance in each measure are reported and warrant further examination when longitudinal outcomes become available.

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