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Association between driving performance and neuropsychological deficits in elderly people with mild cognitive impairment
Poster Presentations: P2 in all fluency measures were not significant. Verbal fluency tests correctly classified 82.7% of the cases. Conclusions: In conclusion, more significant longitudinal declines in CF compared to LF in AD patients were observed. Clinical monitoring and early detection of AD using category fluency might be valuable. And, verbal fluency tasks can be sensitive measures in the differential diagnosis of amnestic MCI and AD in outpatient clinics.
P2-276
ASSOCIATION BETWEEN DRIVING PERFORMANCE AND NEUROPSYCHOLOGICAL DEFICITS IN ELDERLY PEOPLE WITH MILD COGNITIVE IMPAIRMENT
Hyun-Ghang Jeong1, Hyeon Jeong2, Tae Hui Kim2, Ji Won Han3, Jong Chul Youn4, Joon Hyuk Park5, Jin Hyeong Jhoo6, Jung Jae Lee7, Jeong-Lan Kim8, Bong-Jo Kim9, Shin Gyeom Kim10, Seung-Ho Ryu11, Il Han Choo12, Dong Young Lee13, Dong Woo Lee14, Seok Bum Lee15, Ki Woong Kim16, 1Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea; 2Seoul National University Bundang Hospital, Seongnamsi, South Korea; 3Seoul National University Bundang Hospital, Seongnamsi, South Korea; 4 Kyunggi Provincial Hospital for the Elderly, Younginsi, South Korea; 5Jeju National Universtiy School of Medicine & Jeju National University Hospital, Jejusi, South Korea; 6Kanwon National University, Chuncheonsi, South Korea; 7Kyungbook University, Daegu, South Korea; 8Choongnam University Hospital, Daejeon, South Korea; 9Kyunsang University, Jinjusi, South Korea; 10Sunchunhang University, Kyunggi, South Korea; 11Konkuk University Hospital, Seoul, South Korea; 12Seoul National University Hospital, Seoul, South Korea; 13Seoul National University, Seoul, South Korea; 14Inje University Sanggye Paik Hospital, Seoul, South Korea; 15 Dankook University Hospital, Cheonan, South Korea; 16Seoul National University, Seongnamsi, South Korea. Background: Driving skills are negatively influenced by declining cognitive function. It is important for clinicians to identify elderly with cognitive impairment who may be at higher risk for unsafe driving. Methods: We studied 792 older drivers, including 169 with mild cognitive impairment (MCI group) and 623 healthy elders without cognitive impairment (NC group). To examine the driving performance, a history of crashes, traffic citations, reduced driving mileage and situational avoidance were assessed by self-rated questionnaires. Subjects’ neurocognitive function were assessed by CERAD-NP test. Results: There were no differences in a history crashes (0.43 6 0.78/recent 3 years for NC group and 0.47 6 0.78/recent 3 years for MCI group) a nd traffic citations (0.74 6 1.06/recent 3 years for NC group and 0.85 6 1.08/recent 3 years for MCI group) between elders with MCI and healthy elders (P>0.05). However, digit span, word list memory, word list recall, and word list recognition were significantly correlated with situational avoidance of driving (P < 0.05). Conclusions: Our results suggest that mild impairment in memory and attention might contribute on avoiding
P359
Table Results of linear regression analyses with situational avoidance of driving as the dependent variable and the outcomes of neuropsychological test as predictors.
Mini-mental state examination Word list memory Word list recall Word list recognition Constructional praxis Constructional recall Constructional recognition Boston naming test Verbal fluency Digit span Trail making test-A Trail making test-B
r
F
SE
Pvalue
0.08 0.115 0.101 0.096 0.014 0.015 0.026 0.037 0.067 0.082 0.105 0.071
4.91 10.158 7.842 7.045 0.16 0.162 0.505 1.028 3.406 5.108 8.447 3.92
4.027 4.008 4.008 4.017 4.03 4.034 4.03 4.032 4.026 4.019 4.014 4.027
0.027 0.001 0.005 0.008 0.689 0.687 0.477 0.311 0.065 0.024 0.004 0.048
situational driving (i.e., at night, in the rain and in the busy traffic) in the elderly. P2-277
THE CLOCK DRAWING TEST: NORMATIVE DATA FOR THE PORTUGUESE POPULATION
Isabel Santana1, Diana Duro2, Lara Alves3, Sandra Freitas3, Mario Sim~oes3, 1University of Coimbra, Coimbra, Portugal; 2Faculty of Medicine, University of Coimbra, Coimbra, Portugal; 3Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal. Background: The Clock Drawing Test (CDT) was initially purposed to screen constructional abilities in subjects with suspected right parietal lesions but we now acknowledge its much more complex relation with other cognitive abilities, making it especially sensitive to multidomain deficits typical of dementia. Despite its common use in clinical and investigational practices, no study has developed normative data for the Portuguese population, which makes its interpretations limited and subjective. We developed a normative study of the CDT using three scoring systems (Rouleau et al., 1994; Cahn et al., 1996; and Babins et al., 2008) and assessed their psychometric properties and relation to other brief cognitive tests. Methods: The normative sample is composed of a representative sample of cognitively healthy subjects aged 25 and older resident in Portugal continental areas. Cognitive and functional evaluation was performed using the CDT, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Clinical Dementia Rating (CDR). The study participants were stratified according to six demographic variables: gender, age, education, geographic localization, inland/coastal areas and residential area. We present the distribution of CDT scores using the three scoring systems. Statistical analyses were performed through the Statistical Package for the Social Sciences (SPSS version 19.0) and included descriptive analyses, correlation coefficients, analysis of variance and covariance, and multiple linear regression. Results: We assessed 630 subjects, 63.7% female. Mean MMSE result was 28.87 (61.32) and mean MoCA result was 24.54 (63.67). Both scores were significantly correlated with CDT performance on all scoring systems. CDT score presented a linear relation with both age and education, but not with any of the geographical variables studied. Of the three scoring systems studied the Babins et al. (2008) 18 point scoring system overall revealed the best psychometric properties. Normative data were developed considering both age and educational groups (Table 1). Conclusions: The three scoring systems were well correlated with each other and with cognitive screening tests widely used, and had good psychometric properties. Our results may be used in
P2-276
ASSOCIATION BETWEEN DRIVING PERFORMANCE AND NEUROPSYCHOLOGICAL DEFICITS IN ELDERLY PEOPLE WITH MILD COGNITIVE IMPAIRMENT
Hyun-Ghang Jeong1, Hyeon Jeong2, Tae Hui Kim2, Ji Won Han3, Jong Chul Youn4, Joon Hyuk Park5, Jin Hyeong Jhoo6, Jung Jae Lee7, Jeong-Lan Kim8, Bong-Jo Kim9, Shin Gyeom Kim10, Seung-Ho Ryu11, Il Han Choo12, Dong Young Lee13, Dong Woo Lee14, Seok Bum Lee15, Ki Woong Kim16, 1Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea; 2Seoul National University Bundang Hospital, Seongnamsi, South Korea; 3Seoul National University Bundang Hospital, Seongnamsi, South Korea; 4 Kyunggi Provincial Hospital for the Elderly, Younginsi, South Korea; 5Jeju National Universtiy School of Medicine & Jeju National University Hospital, Jejusi, South Korea; 6Kanwon National University, Chuncheonsi, South Korea; 7Kyungbook University, Daegu, South Korea; 8Choongnam University Hospital, Daejeon, South Korea; 9Kyunsang University, Jinjusi, South Korea; 10Sunchunhang University, Kyunggi, South Korea; 11Konkuk University Hospital, Seoul, South Korea; 12Seoul National University Hospital, Seoul, South Korea; 13Seoul National University, Seoul, South Korea; 14Inje University Sanggye Paik Hospital, Seoul, South Korea; 15 Dankook University Hospital, Cheonan, South Korea; 16Seoul National University, Seongnamsi, South Korea. Background: Driving skills are negatively influenced by declining cognitive function. It is important for clinicians to identify elderly with cognitive impairment who may be at higher risk for unsafe driving. Methods: We studied 792 older drivers, including 169 with mild cognitive impairment (MCI group) and 623 healthy elders without cognitive impairment (NC group). To examine the driving performance, a history of crashes, traffic citations, reduced driving mileage and situational avoidance were assessed by self-rated questionnaires. Subjects’ neurocognitive function were assessed by CERAD-NP test. Results: There were no differences in a history crashes (0.43 6 0.78/recent 3 years for NC group and 0.47 6 0.78/recent 3 years for MCI group) a nd traffic citations (0.74 6 1.06/recent 3 years for NC group and 0.85 6 1.08/recent 3 years for MCI group) between elders with MCI and healthy elders (P>0.05). However, digit span, word list memory, word list recall, and word list recognition were significantly correlated with situational avoidance of driving (P < 0.05). Conclusions: Our results suggest that mild impairment in memory and attention might contribute on avoiding
P359
Table Results of linear regression analyses with situational avoidance of driving as the dependent variable and the outcomes of neuropsychological test as predictors.
Mini-mental state examination Word list memory Word list recall Word list recognition Constructional praxis Constructional recall Constructional recognition Boston naming test Verbal fluency Digit span Trail making test-A Trail making test-B
r
F
SE
Pvalue
0.08 0.115 0.101 0.096 0.014 0.015 0.026 0.037 0.067 0.082 0.105 0.071
4.91 10.158 7.842 7.045 0.16 0.162 0.505 1.028 3.406 5.108 8.447 3.92
4.027 4.008 4.008 4.017 4.03 4.034 4.03 4.032 4.026 4.019 4.014 4.027
0.027 0.001 0.005 0.008 0.689 0.687 0.477 0.311 0.065 0.024 0.004 0.048
situational driving (i.e., at night, in the rain and in the busy traffic) in the elderly. P2-277
THE CLOCK DRAWING TEST: NORMATIVE DATA FOR THE PORTUGUESE POPULATION
Isabel Santana1, Diana Duro2, Lara Alves3, Sandra Freitas3, Mario Sim~oes3, 1University of Coimbra, Coimbra, Portugal; 2Faculty of Medicine, University of Coimbra, Coimbra, Portugal; 3Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal. Background: The Clock Drawing Test (CDT) was initially purposed to screen constructional abilities in subjects with suspected right parietal lesions but we now acknowledge its much more complex relation with other cognitive abilities, making it especially sensitive to multidomain deficits typical of dementia. Despite its common use in clinical and investigational practices, no study has developed normative data for the Portuguese population, which makes its interpretations limited and subjective. We developed a normative study of the CDT using three scoring systems (Rouleau et al., 1994; Cahn et al., 1996; and Babins et al., 2008) and assessed their psychometric properties and relation to other brief cognitive tests. Methods: The normative sample is composed of a representative sample of cognitively healthy subjects aged 25 and older resident in Portugal continental areas. Cognitive and functional evaluation was performed using the CDT, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Clinical Dementia Rating (CDR). The study participants were stratified according to six demographic variables: gender, age, education, geographic localization, inland/coastal areas and residential area. We present the distribution of CDT scores using the three scoring systems. Statistical analyses were performed through the Statistical Package for the Social Sciences (SPSS version 19.0) and included descriptive analyses, correlation coefficients, analysis of variance and covariance, and multiple linear regression. Results: We assessed 630 subjects, 63.7% female. Mean MMSE result was 28.87 (61.32) and mean MoCA result was 24.54 (63.67). Both scores were significantly correlated with CDT performance on all scoring systems. CDT score presented a linear relation with both age and education, but not with any of the geographical variables studied. Of the three scoring systems studied the Babins et al. (2008) 18 point scoring system overall revealed the best psychometric properties. Normative data were developed considering both age and educational groups (Table 1). Conclusions: The three scoring systems were well correlated with each other and with cognitive screening tests widely used, and had good psychometric properties. Our results may be used in