Driving Attention Improved With Drugs Used in Alzheimer's Patients
CHICAGO -- July 29, 2008 -- Patients with early Alzheimer's disease who are being treated with an acetylcholinesterase inhibitor have better motor vehicle driving skills compared with those who are not treated with these agents, according to research presented here at the 2008 International Conference on Alzheimer's Disease (ICAD).
Lori A. Daiello, PharmD, Brown University, Providence, Rhode Island, presented the study findings in a poster session on July 28.
"Cholinesterase inhibitor-treated drivers with mild Alzheimer's disease demonstrated faster reaction times and greater response accuracy under conditions of higher attentional burden than cholinesterase inhibitor-naïve drivers," said Dr. Daiello. "These effects may mitigate or delay aspects of driving impairment in drivers with early-stage Alzheimer's disease."
Dr. Daiello and colleagues recruited 35 patients diagnosed with early-stage Alzheimer's disease who were not taking cholinesterase inhibitor therapy. The final analysis included the 24 patients who completed the study. These patients had an average age of 75 years and had an average of 58 years as a licensed motor vehicle driver.
Most of the patients (91.5%) received donepezil, and the rest were prescribed galantamine. About half the subjects were women. All were evaluated for visual attention, including simulated driving tests, before they started the cholinesterase inhibitor and after 3 months of treatment.
The average rate of correct hits on a dual-task evaluation was 90% before patients started cholinesterase inhibitor therapy and 93% after they were treated with the cholinesterase inhibitor therapy. The difference reached statistical significance at the P = .011 level.
Other significant improvements with cholinesterase inhibitor therapy were in overall task accuracy (P = .02) and ability to accurately maintain lane position while driving (P = .03).
"Cortical cholinergic transmission has been shown to mediate attentional effort in human and animal models," Dr. Daiello said. "By increasing central acetylcholine, cholinesterase inhibitors may ameliorate disease-related attentional impairment in drivers with mild Alzheimer's disease."
She added that "improvements in visual attention with cholinesterase inhibitors could have important implications for patients who continue to drive in the early stages of Alzheimer's disease."
[Presentation title: Cholinesterase Inhibitors Improve Visual Attention in Drivers With Alzheimer's Disease. Poster P2-426]
