Summary:
Objectives: The aim was to examine the prevalence of neuropsychiatric symptoms
in a-MCI individuals and whether these symptoms can predict a worse driving
performance while driving in a simulator. Methods: In the study 31 a-MCI
individuals (age=70.9±9.4) and 24 control subjects with (age=67.9±6.2) were
tested in basic driving measures. Additionally, a-MCI participants were passed
a neuropsychiatric evaluation including the Neuropsychiatric Inventory, the
Patient Health Questionnaire and the Geriatric Depression scale. Results: The
most frequent symptoms in a-MCI individuals found to be irritability (52%),
depression (45%), anxiety (45%), aggression (23%), apathy (23%) and sleep
disturbances (19%). While driving in a simulator, a t-test analysis showed that
a-MCI drivers performed slower, demonstrated reduced average speed, and higher
accident probability only in the rural area. When we examined the relationship
of the driving behavior and neuropsychiatric symptoms among the a-MCI group,
the results showed that in the rural area depression and irritability from the
NPI predicted the increase of the sudden deactivation of the engine, whilst
depression from PHQ-9 predicted an increase on the average speed of the
drivers. In the urban area depression, anxiety, and depressive symptoms (PHQ-9)
predicted the increased sudden deactivation of the engine and the average
reaction time, when sleep changes predicted only the deactivation. Multiple
regression analysis indicated the unique contribution of anxiety, sleep changes
and depressive symptoms from PHQ-9 on the increased sudden deactivation of the
engine, whilst the PHQ-9 contributed as well on the increased average reaction
time, in the urban environment. The presence of neuropsychiatric symptoms was
also related with changes in the driving performance of a-MCI drivers,
including the average speed, the distance from the ahead car, the reaction time
and the deactivation of the car machine. Conclusion: This is the first study to
have examined the relationship between the neuropsychiatric symptoms and
driving performance in a-MCI individuals. The results indicate that the
severity of depression, anxiety, sleep changes and irritability symptoms can
predict changes on the driving behavior of a-MCI drivers, whilst the presence
of depression, anxiety and irritability is also related with these changes.
Keywords:
Mild cognitive impairment, Neuropsychiatric symptoms, Older adults, Driving simulator, Driving performance
