Ganesh M Babulal1,2, Suzie Chen3, Monique M Williams4, Jean-Francois Trani5, Parul Bakhshi6,5, Grace L Chao7, Sarah H Stout1,2, Anne M Fagan1,2,8, Tammie L S Benzinger1,9,10, David M Holtzman2,8, John C Morris1,2,8,9,11,12,6, Catherine M Roe1,2. 1. Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA. 2. Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA. 3. St. Louis College of Pharmacy, St. Louis, MO, USA. 4. BJC Medical Group, St. Louis, MO, USA. 5. Brown School, Washington University, St. Louis, MO, USA. 6. Department of Occupational Therapy, Washington University, School of Medicine, St. Louis, MO, USA. 7. Chicago State University, Chicago, IL, USA. 8. Hope Center for Neurological Disorders, Washington University, School of Medicine, St. Louis, MO, USA. 9. Department of Radiology, Washington University, School of Medicine, St. Louis, MO, USA. 10. Department of Neurosurgery, Washington University, School of Medicine, St. Louis, MO, USA. 11. Department of Pathology and Immunology, Washington University, School of Medicine, St. Louis, MO, USA. 12. Department of Physical Therapy, Washington University, School of Medicine, St. Louis, MO, USA.
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-β42 [Aβ42], tau, phosphorylated tau181 [ptau181]), 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 ptau181 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.
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-β42 [Aβ42], tau, phosphorylated tau181 [ptau181]), 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 ptau181 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.
Authors: John C Morris; Sandra Weintraub; Helena C Chui; Jeffrey Cummings; Charles Decarli; Steven Ferris; Norman L Foster; Douglas Galasko; Neill Graff-Radford; Elaine R Peskind; Duane Beekly; Erin M Ramos; Walter A Kukull Journal: Alzheimer Dis Assoc Disord Date: 2006 Oct-Dec Impact factor: 2.703
Authors: Ganesh M Babulal; Sarah H Stout; Tammie L S Benzinger; Brian R Ott; David B Carr; Mollie Webb; Cindy M Traub; Aaron Addison; John C Morris; David K Warren; Catherine M Roe Journal: J Appl Gerontol Date: 2017-01-29
Authors: B R Ott; W C Heindel; G D Papandonatos; E K Festa; J D Davis; L A Daiello; J C Morris Journal: Neurology Date: 2008-01-23 Impact factor: 9.910
Authors: Ganesh M Babulal; Nupur Ghoshal; Denise Head; Elizabeth K Vernon; David M Holtzman; Tammie L S Benzinger; Anne M Fagan; John C Morris; Catherine M Roe Journal: Am J Geriatr Psychiatry Date: 2016-04-19 Impact factor: 4.105
Authors: Catherine M Roe; Ganesh M Babulal; Denise M Head; Sarah H Stout; Elizabeth K Vernon; Nupur Ghoshal; Brad Garland; Peggy P Barco; Monique M Williams; Ann Johnson; Rebecca Fierberg; M Scot Fague; Chengjie Xiong; Elizabeth Mormino; Elizabeth A Grant; David M Holtzman; Tammie L S Benzinger; Anne M Fagan; Brian R Ott; David B Carr; John C Morris Journal: Alzheimers Dement (N Y) Date: 2017-01
Authors: Xuan Di; Rongye Shi; Carolyn DiGuiseppi; David W Eby; Linda L Hill; Thelma J Mielenz; Lisa J Molnar; David Strogatz; Howard F Andrews; Terry E Goldberg; Barbara H Lang; Minjae Kim; Guohua Li Journal: Geriatrics (Basel) Date: 2021-04-23