Psychiatry Investig.
2018 Dec;15(12):1162-1167. 10.30773/pi.2018.10.10.3.
Subcortical Ischemic Change as a Predictor of Driving Cessation in the Elderly
- Affiliations
-
- 1Department of General Psychiatry, National Center for Mental Health, Seoul, Republic of Korea.
- 2Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea. sjsonpsy@ajou.ac.kr
- 3Department of Psychiatry, National Medical Center of Korea, Seoul, Republic of Korea.
- 4Department of Neurology, Inha University College of Medicine, Incheon, Republic of Korea.
- 5Department of Neurology, Samsung Medical Center, Seoul, Republic of Korea.
- 6Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea.
- 7Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea.
- 8Department of Psychiatry, Ajou Good Hospital, Suwon, Republic of Korea.
- 9Department of Brain Science, Ajou University School of Medicine, Suwon, Republic of Korea.
- KMID: 2434765
- DOI: http://doi.org/10.30773/pi.2018.10.10.3
Abstract
OBJECTIVE
Motor, perceptual, and cognitive functions are known to affect driving competence. Subcortical ischemic changes on brain magnetic resonance imaging (MRI) can reflect reduction in cognitive and motor performance. However, few studies have reported the relationship between subcortical ischemic changes and driving competence of the elderly. Thus, the objective of this study was to investigate the association between subcortical ischemic changes on MRI and driving abilities of the elderly.
METHODS
Participants (n=540) were drawn from a nationwide, multicenter, hospital-based, longitudinal cohort. Each participant underwent MRI scan and interview for driving capacity categorized into "˜now driving' and "˜driving cessation (driven before, not driving now)'. Participants were divided into three groups (mild, n=389; moderate, n=116; and severe, n=35) depending on the degree of white matter hyperintensity (WMH) on MRI at baseline. Driving status was evaluated at follow-up. Statistical analyses were conducted using χ2 test, analysis of variance (ANOVA), structured equation model (SEM), and generalized estimating equation (GEE).
RESULTS
In SEM, greater baseline degree of WMH was directly associated with driving cessation regardless of cognitive or motor dysfunction (β=-0.110, p < 0.001). In GEE models after controlling for age, sex, education, cognitive, and motor dysfunction, more severe change in the degree of WMH was associated with faster change from "˜now driving' state to "˜driving cessation' state over time in the elderly (β=-0.508, p < 0.001).
CONCLUSION
In both cross-sectional and longitudinal results, the degree of subcortical ischemic change on MRI might predict driving cessation in the elderly.
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