Cortical atrophy and leukoaraiosis, imaging markers of cerebrovascular small vessel disease, are associated with driving behavior changes among cognitively normal older adults

Authors

• Ganesh M. Babulal, Department of Neurology, Washington University in St. Louis, MO, USA; Institute of Public Health, Washington University in St. Louis, St. Louis, MO, USA; Department of Psychology, Faculty of Humanities, University of Johannesburg, South Africa; Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington DC, USA. Electronic address: babulalg@wustl.edu.
• Ling Chen, Division of Biostatistics, Washington University in St. Louis, MO, USA.
• David B. Carr, Department of Medicine, Division of Geriatrics & Nutritional Sciences, Washington University in St. Louis, MO, USA.
• Ann M. Johnson, Center for Clinical Studies, Washington University in St. Louis, MO, USA.
• Joshua S. Shimony, Mallinckrodt Institute of Radiology, Washington University in St. Louis, MO, USA.
• Jason Doherty, Department of Neurology, Washington University in St. Louis, MO, USA.
• Samantha Murphy, Department of Neurology, Washington University in St. Louis, MO, USA.
• Alexis Walker, Department of Neurology, Washington University in St. Louis, MO, USA.
• Hailee Domash, Department of Neurology, Washington University in St. Louis, MO, USA.
• Russ Hornbeck, Mallinckrodt Institute of Radiology, Washington University in St. Louis, MO, USA.
• Sarah Keefe, Mallinckrodt Institute of Radiology, Washington University in St. Louis, MO, USA.
• Shaney Flores, Mallinckrodt Institute of Radiology, Washington University in St. Louis, MO, USA.
• Cyrus A. Raji, Department of Neurology, Washington University in St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University in St. Louis, MO, USA.
• John C. Morris, Department of Neurology, Washington University in St. Louis, MO, USA; Institute of Public Health, Washington University in St. Louis, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St. Louis, MO 63110, USA.
• Beau M. Ances, Department of Neurology, Washington University in St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University in St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St. Louis, MO 63110, USA.
• Tammie L. Benzinger, Mallinckrodt Institute of Radiology, Washington University in St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St. Louis, MO 63110, USA.

Document Type

Journal Article

Publication Date

3-22-2023

Journal

Journal of the neurological sciences

Volume

448

DOI

10.1016/j.jns.2023.120616

Keywords

Cerebrovascular small vessel disease; Cortical atrophy; Driving; Functional decline; Older adults; White matter hyperintensities

Abstract

BACKGROUND: Cerebral small vessel disease (CSVD) as measured by cortical atrophy and white matter hyperintensities [leukoaraiosis], captured via magnetic resonance imaging (MRI) are increasing in prevalence due to the growth of the aging population and an increase in cardiovascular risk factors in the population. CSVD impacts cognitive function and mobility, but it is unclear if it affects complex, functional activities like driving. METHODS: In a cohort of 163 cognitively normal, community-dwelling older adults (age ≥ 65), we compared naturalistic driving behavior with mild/moderate leukoaraiosis, cortical atrophy, or their combined rating in a clinical composite termed, aging-related changes to those without any, over a two-and-a-half-year period. RESULTS: Older drivers with mild or moderate cortical atrophy and aging-related changes (composite) experienced a greater decrease in the number of monthly trips which was due to a decrease in the number of trips made within a one-to-five-mile diameter from their residence. Older drivers with CSVD experience a larger reduction in daily driving behaviors than drivers without CSVD, which may serve as an early neurobehavioral marker for functional decline. CONCLUSIONS: As CSVD markers, leukoaraiosis and cortical atrophy are standard MRI metrics that are widely available and can be used for screening individuals at higher risk for driving safety risk and decline in community mobility.

APA Citation

Babulal, Ganesh M.; Chen, Ling; Carr, David B.; Johnson, Ann M.; Shimony, Joshua S.; Doherty, Jason; Murphy, Samantha; Walker, Alexis; Domash, Hailee; Hornbeck, Russ; Keefe, Sarah; Flores, Shaney; Raji, Cyrus A.; Morris, John C.; Ances, Beau M.; and Benzinger, Tammie L., "Cortical atrophy and leukoaraiosis, imaging markers of cerebrovascular small vessel disease, are associated with driving behavior changes among cognitively normal older adults" (2023). GW Authored Works. Paper 2553.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2553

Department

Clinical Research and Leadership