Enhanced Insight into Factors Impacting Driving Ability Across Manual Dexterity, Satisfaction with Managing Daily Activities and Select Cognitive Domains in People with Dementia Associated Disease

Abstract

AbstractBackgroundDementia associated diseases (DAD) refers to a group of disorders characterized by progressive cognitive impairment (CI) that adversely influences ability to function independently in real world activities. CI may reflect abnormalities across multiple cognitive domains (CD) to varying degrees. Successful completion of activities of daily living (ADL) is progressively impaired DAD. Symptom recognition by family and clinicians typically present following irreversible damage, highlighting a demand for effective methods of early DAD diagnosis and treatment. Neurocognitive screening tools combined with patient reported outcomes (PRO) might provide deeper insight into the patterns and progression of DAD. Comparison of PRO across Upper Extremity Function Score (UEF), Self‐Efficacy for Managing Daily Activities (SEMDA), and cognitive performance measures with driving status in PwDAD might enhance understanding of disability across a continuum and identify the medical necessity of transportation assistance for PwDAD.MethodRetrospective review of examiner independent information collected in the course of routine care of a population of PwDAD including demographics, driving status, UEF, SEMDA, executive function (NT‐EF), and motor function, reflecting time to move and accuracy, (NT‐MF) of a multi‐domain computerized cognitive test (CTB). T‐tests were utilized for analysis with significance (p<0.05).Result529 PwDAD (59% female, average age 74.4 +/‐ 8.8 years) provided the data collected to compare patient driving status with UEF, SEMDA, NT‐MF, NT‐EF scores. Statistically significant (p<0.01) relationships were identified between driving status and PRO score for all domains: UEF, SEMDA, NT‐MF, and NT‐EF.ConclusionActive driving status in PwDAD is associated with better scores on a self‐reported upper extremity ability profile, self‐efficacy for managing daily activities as well as better executive function and cognitively defined motor function planning. While effective collaboration across a cognitive network provides for driving, simultaneous monitoring of UEF and SEMDA in conjunction with both NT‐MF, and NT‐EF might provide enhanced insight into driving impairment along a continuum. Improved awareness of the multiple potential paths of impairment and real‐world impact can offer proactive opportunities for intervention as well as novel important endpoints to measure therapy efficacy.