Dementia Associated Disorders, Driving Status and the Relationships between Communication, Anxiety and Objective Cognitive Testing

Abstract

AbstractBackgroundDementia associated diseases (DAD) refers to a heterogeneous group of disorders that are clinically characterized by progressive cognitive impairment (CI) that ultimately adversely influences an individual’s ability to function independently. CI may reflect abnormalities across multiple cognitive domains to varying degrees and combinations across various cognitive domains (CD). Identifying treatment needs and discussing treatment options requires ongoing communication between patient and provider over the disease continuum; communication capacity may be compromised but underappreciated. Impaired verbal and episodic memory function in people with DAD (PwDAD) can adversely impact communication abilities. Maintaining an effective long‐term treatment plan requires consistent monitoring of both performance ability and patient perspective (patient reported outcomes, PRO) across a continuum of patient needs (health, safety, and QoL).MethodRetrospective review of information obtained in the course of routine care including driving status, Neuro QOL‐Anxiety Short‐Form (A‐SF); Neuro QOL‐Communication Short‐Form (C‐SF); validated multi‐domain computerized cognitive assessment battery (CAB). CAB Domain Score of Verbal Function (CAB‐V) and Memory Function (CAB‐M). CAB and PRO were completed without provider influence.Result530 PwDAD (62% female, average age 71.9 +/‐ 14.3 years) was used to compare patient driving status with A‐SF, C‐SF, NT‐V, NT‐M scores. T‐Tests assuming both equal and unequal variances comparing multiple PRO scores to driving status determined significance at (p<0.01). Statistically significant relationships were identified between driving status and: A‐SF, C‐SF, CAB‐V, and CAB‐M.ConclusionSelf‐reported anxiety and ability to communicate, objective impairment in verbal, and memory function are related to driving status in PwDAD. Appreciation of disease impact, whether perceived or performance ability, across a continuum should be incorporated in routine care and monitoring of dementia disorders to optimize care and outcome by identifying issues of concern that have both visible and invisible impact both patients and clinicians to design an effective plan of care to accommodate patient centric impairment and needs. Standardized methods of routine PRO collection concerning various aspects of real‐world health outside of a clinic encounter are important to building an effective holistic treatment plan.