Using the A/T/N Framework to Examine Driving in Preclinical Alzheimer’s Disease
Catherine M. Roe,
Ganesh M. Babulal,
Sarah H. Stout,
David B. Carr,
Monique M. Williams,
Tammie L. S. Benzinger,
Anne M. Fagan,
David M. Holtzman,
Beau M. Ances,
John C. Morris
Affiliations
Catherine M. Roe
Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
Ganesh M. Babulal
Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
Sarah H. Stout
Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
David B. Carr
Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
Monique M. Williams
VITAS Healthcare, St. Louis, MO 63110, USA
Tammie L. S. Benzinger
Knight Alzheimer Disease Research Center, Departments of Radiology and Neurosurgery, Washington University School of Medicine, St. Louis, MO 63110, USA
Anne M. Fagan
Knight Alzheimer Disease Research Center, Department of Neurology, the Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO 63110, USA
David M. Holtzman
Knight Alzheimer Disease Research Center, Department of Neurology, the Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO 63110, USA
Beau M. Ances
Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
John C. Morris
Knight Alzheimer Disease Research Center, Departments of Neurology, Neurosurgery, Occupational Therapy, Pathology and Immunology, Physical Therapy, Washington University School of Medicine, St. Louis, MO 63110, USA
The A/T/N classification system is the foundation of the 2018 NIA-AA Research Framework and is intended to guide the Alzheimer disease (AD) research agenda for the next 5–10 years. Driving is a widespread functional activity that may be particularly useful in investigation of functional changes in pathological AD before onset of cognitive symptoms. We examined driving in preclinical AD using the A/T/N framework and found that the onset of driving difficulties is most associated with abnormality of both amyloid and tau pathology, rather than amyloid alone. These results have implications for participant selection into clinical trials and for the application time of interventions aimed at prolonging the time of safe driving among older adults with preclinical AD.
