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Differential Contributions of Selective Attention and Sensory Integration to Driving Performance in Healthy Aging and Alzheimer’s Disease

Published online by Cambridge University Press:  28 December 2017

Umesh M. Venkatesan ,
Elena K. Festa ,
Brian R. Ott  and
William C. Heindel
Umesh M. Venkatesan
Affiliation:
Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, Rhode Island
Elena K. Festa*
Affiliation:
Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, Rhode Island
Brian R. Ott
Affiliation:
Department of Neurology, Alpert Medical School, Brown University, Providence, Rhode Island
William C. Heindel
Affiliation:
Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, Rhode Island
*
Correspondence and reprint requests to: Elena K. Festa, Department of Cognitive, Linguistic, and Psychological Sciences, 190 Thayer Street, Brown University, Providence, RI 02912. E-mail: [email protected]
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Abstract

Objectives: Patients with Alzheimer’s disease (AD) demonstrate deficits in cross-cortical feature binding distinct from age-related changes in selective attention. This may have consequences for driving performance given its demands on multisensory integration. We examined the relationship of visuospatial search and binding to driving in patients with early AD and elderly controls (EC). Methods: Participants (42 AD; 37 EC) completed search tasks requiring either luminance-motion (L-M) or color-motion (C-M) binding, analogs of within and across visual processing stream binding, respectively. Standardized road test (RIRT) and naturalistic driving data (CDAS) were collected alongside clinical screening measures. Results: Patients performed worse than controls on most cognitive and driving indices. Visual search and clinical measures were differentially related to driving behavior across groups. L-M search and Trail Making Test (TMT-B) were associated with RIRT performance in controls, while C-M binding, TMT-B errors, and Clock Drawing correlated with CDAS performance in patients. After controlling for demographic and clinical predictors, L-M reaction time significantly predicted RIRT performance in controls. In patients, C-M binding made significant contributions to CDAS above and beyond demographic and clinical predictors. RIRT and C-M binding measures accounted for 51% of variance in CDAS performance in patients. Conclusions: Whereas selective attention is associated with driving behavior in EC, cross-cortical binding appears most sensitive to driving in AD. This latter relationship may emerge only in naturalistic settings, which better reflect patients’ driving behavior. Visual integration may offer distinct insights into driving behavior, and thus has important implications for assessing driving competency in early AD. (JINS, 2018, 24, 486–497)

Keywords

CognitionDementiaGeriatricsOlder driversPerceptionVisual search
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 5 , May 2018 , pp. 486 - 497
Copyright
Copyright © The International Neuropsychological Society 2017 

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