Differential Contributions of Selective Attention and Sensory Integration to Driving Performance in Healthy Aging and Alzheimer’s Disease

Objectives: Patients with Alzheimer’s disease (AD) demonstrate deficits in cross-cortical feature binding distinct from age-related changes in selective attention. This may have consequences for driving performance given its demands on multisensory integration. We examined the relationship of visuos...

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Bibliographic Details
Published in:Journal of the International Neuropsychological Society 2018-05, Vol.24 (5), p.486-497
Main Authors: Venkatesan, Umesh M., Festa, Elena K., Ott, Brian R., Heindel, William C.
Format: Article
Language:English
Subjects:
Aged
Aging
Alzheimer Disease - psychology
Alzheimer's disease
Appetitive Behavior
Attention
Automobile Driving - psychology
Case-Control Studies
Cognitive ability
Cortex
Dementia
Female
Geriatrics
Humans
Information processing
Male
Neurodegenerative diseases
Neuropsychology
Perception
Psychomotor Performance
Reaction Time
Reaction time task
Sensory integration
Trail Making Test
Visual perception
Visual task performance
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Summary:Objectives: Patients with Alzheimer’s disease (AD) demonstrate deficits in cross-cortical feature binding distinct from age-related changes in selective attention. This may have consequences for driving performance given its demands on multisensory integration. We examined the relationship of visuospatial search and binding to driving in patients with early AD and elderly controls (EC). Methods: Participants (42 AD; 37 EC) completed search tasks requiring either luminance-motion (L-M) or color-motion (C-M) binding, analogs of within and across visual processing stream binding, respectively. Standardized road test (RIRT) and naturalistic driving data (CDAS) were collected alongside clinical screening measures. Results: Patients performed worse than controls on most cognitive and driving indices. Visual search and clinical measures were differentially related to driving behavior across groups. L-M search and Trail Making Test (TMT-B) were associated with RIRT performance in controls, while C-M binding, TMT-B errors, and Clock Drawing correlated with CDAS performance in patients. After controlling for demographic and clinical predictors, L-M reaction time significantly predicted RIRT performance in controls. In patients, C-M binding made significant contributions to CDAS above and beyond demographic and clinical predictors. RIRT and C-M binding measures accounted for 51% of variance in CDAS performance in patients. Conclusions: Whereas selective attention is associated with driving behavior in EC, cross-cortical binding appears most sensitive to driving in AD. This latter relationship may emerge only in naturalistic settings, which better reflect patients’ driving behavior. Visual integration may offer distinct insights into driving behavior, and thus has important implications for assessing driving competency in early AD. (JINS, 2018, 24, 486–497)
ISSN:1355-6177
1469-7661
DOI:10.1017/S1355617717001291