Clinical Predictors of Driving Status in Huntington's Disease
Identifieur interne : 001169 ( Main/Exploration ); précédent : 001168; suivant : 001170Clinical Predictors of Driving Status in Huntington's Disease
Auteurs : Leigh J. Beglinger [États-Unis] ; Luke Prest [États-Unis] ; James A. Mills [États-Unis] ; Jane S. Paulsen [États-Unis] ; Megan M. Smith [États-Unis] ; Pedro Gonzalez-Alegre [États-Unis] ; Kelly C. Rowe [États-Unis] ; Peggy Nopoulos [États-Unis] ; Ergun Y. Uc [États-Unis]Source :
- Movement disorders [ 0885-3185 ] ; 2012.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Adult, Aged, Attention, Automobile Driving (psychology), Cognition Disorders (etiology), Cognition Disorders (psychology), Cognitive disorder, Data Interpretation, Statistical, Dementia, Disease Progression, Female, Humans, Huntington Disease (psychology), Huntington disease, Learning, Male, Mental Status Schedule, Middle Aged, Motor Skills, Nervous system diseases, Neurologic Examination, Neuropsychological Tests, Psychomotor Performance, Regression Analysis, Risk Factors.
- MESH :
- etiology : Cognition Disorders.
- psychology : Automobile Driving, Cognition Disorders, Huntington Disease.
- Adult, Aged, Attention, Data Interpretation, Statistical, Disease Progression, Female, Humans, Learning, Male, Mental Status Schedule, Middle Aged, Motor Skills, Neurologic Examination, Neuropsychological Tests, Psychomotor Performance, Regression Analysis, Risk Factors.
Abstract
The aim of this study was to identify the motor, cognitive, and behavioral determinants of driving status and risk factors for driving cessation in Huntington's disease (HD). Seventy-four patients with HD were evaluated for cognitive, motor, psychiatric, and functional status using a standardized battery (Unified Huntington's Disease Rating Scale [UHDRS] and supplemental neuropsychological testing) during a research clinic visit. Chart review was used to categorize patients into two driving status categories: (1) "currently driving" included those driving and driving but with clinician recommendation to restrict, and (2) "not driving" included those with clinician recommendation to cease driving and those not currently driving because of HD. Multi- and univariate logistic regression was used to identify significant clinical predictors of those driving versus not driving. Global cognitive performance and UHDRS Total Functional Capacity scores provided the best predictive model of driving cessation (Nagelkerke R2 = 0.65; P < 0.0001). Measures of learning (P = 0.006) and psychomotor speed/attention (P = 0.003) accounted for the overall cognitive finding. In univariate analyses, numerous cognitive, motor, and daily functioning items were significantly associated with driving. Although driving status is associated with many aspects of the disease, results suggest that the strongest association is with cognitive performance. A detailed cognitive evaluation is an important component of multidisciplinary clinical assessment in patients with HD who are driving.
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Affiliations:
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Beglinger</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Psychiatry, University of Iowa Carver College of Medicine</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Elks Rehab Hospital</s1><s2>Boise, Idaho</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Idaho</region></placeName></affiliation></author><author><name sortKey="Prest, Luke" sort="Prest, Luke" uniqKey="Prest L" first="Luke" last="Prest">Luke Prest</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Psychiatry, University of Iowa Carver College of Medicine</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region></placeName></affiliation></author><author><name sortKey="Mills, James A" sort="Mills, James A" uniqKey="Mills J" first="James A." last="Mills">James A. Mills</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Psychiatry, University of Iowa Carver College of Medicine</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region></placeName></affiliation></author><author><name sortKey="Paulsen, Jane S" sort="Paulsen, Jane S" uniqKey="Paulsen J" first="Jane S." last="Paulsen">Jane S. Paulsen</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Psychiatry, University of Iowa Carver College of Medicine</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Neurology, University of Iowa Carver College of Medicine</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region></placeName></affiliation></author><author><name sortKey="Smith, Megan M" sort="Smith, Megan M" uniqKey="Smith M" first="Megan M." last="Smith">Megan M. Smith</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Psychiatry, University of Iowa Carver College of Medicine</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region></placeName></affiliation></author><author><name sortKey="Gonzalez Alegre, Pedro" sort="Gonzalez Alegre, Pedro" uniqKey="Gonzalez Alegre P" first="Pedro" last="Gonzalez-Alegre">Pedro Gonzalez-Alegre</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Neurology, University of Iowa Carver College of Medicine</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region></placeName></affiliation></author><author><name sortKey="Rowe, Kelly C" sort="Rowe, Kelly C" uniqKey="Rowe K" first="Kelly C." last="Rowe">Kelly C. Rowe</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Psychiatry, University of Iowa Carver College of Medicine</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region></placeName></affiliation></author><author><name sortKey="Nopoulos, Peggy" sort="Nopoulos, Peggy" uniqKey="Nopoulos P" first="Peggy" last="Nopoulos">Peggy Nopoulos</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Psychiatry, University of Iowa Carver College of Medicine</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region></placeName></affiliation></author><author><name sortKey="Uc, Ergun Y" sort="Uc, Ergun Y" uniqKey="Uc E" first="Ergun Y." last="Uc">Ergun Y. Uc</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Neurology, University of Iowa Carver College of Medicine</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Neurology Service, Veterans Affairs Medical Center</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Attention</term><term>Automobile Driving (psychology)</term><term>Cognition Disorders (etiology)</term><term>Cognition Disorders (psychology)</term><term>Cognitive disorder</term><term>Data Interpretation, Statistical</term><term>Dementia</term><term>Disease Progression</term><term>Female</term><term>Humans</term><term>Huntington Disease (psychology)</term><term>Huntington disease</term><term>Learning</term><term>Male</term><term>Mental Status Schedule</term><term>Middle Aged</term><term>Motor Skills</term><term>Nervous system diseases</term><term>Neurologic Examination</term><term>Neuropsychological Tests</term><term>Psychomotor Performance</term><term>Regression Analysis</term><term>Risk Factors</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cognition Disorders</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Automobile Driving</term><term>Cognition Disorders</term><term>Huntington Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Attention</term><term>Data Interpretation, Statistical</term><term>Disease Progression</term><term>Female</term><term>Humans</term><term>Learning</term><term>Male</term><term>Mental Status Schedule</term><term>Middle Aged</term><term>Motor Skills</term><term>Neurologic Examination</term><term>Neuropsychological Tests</term><term>Psychomotor Performance</term><term>Regression Analysis</term><term>Risk Factors</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Chorée de Huntington</term><term>Trouble cognitif</term><term>Démence</term><term>Pathologie du système nerveux</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study was to identify the motor, cognitive, and behavioral determinants of driving status and risk factors for driving cessation in Huntington's disease (HD). Seventy-four patients with HD were evaluated for cognitive, motor, psychiatric, and functional status using a standardized battery (Unified Huntington's Disease Rating Scale [UHDRS] and supplemental neuropsychological testing) during a research clinic visit. Chart review was used to categorize patients into two driving status categories: (1) "currently driving" included those driving and driving but with clinician recommendation to restrict, and (2) "not driving" included those with clinician recommendation to cease driving and those not currently driving because of HD. Multi- and univariate logistic regression was used to identify significant clinical predictors of those driving versus not driving. Global cognitive performance and UHDRS Total Functional Capacity scores provided the best predictive model of driving cessation (Nagelkerke R<sup>2</sup> = 0.65; P < 0.0001). Measures of learning (P = 0.006) and psychomotor speed/attention (P = 0.003) accounted for the overall cognitive finding. In univariate analyses, numerous cognitive, motor, and daily functioning items were significantly associated with driving. Although driving status is associated with many aspects of the disease, results suggest that the strongest association is with cognitive performance. A detailed cognitive evaluation is an important component of multidisciplinary clinical assessment in patients with HD who are driving.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Idaho</li><li>Iowa</li></region></list><tree><country name="États-Unis"><region name="Iowa"><name sortKey="Beglinger, Leigh J" sort="Beglinger, Leigh J" uniqKey="Beglinger L" first="Leigh J." last="Beglinger">Leigh J. Beglinger</name></region><name sortKey="Beglinger, Leigh J" sort="Beglinger, Leigh J" uniqKey="Beglinger L" first="Leigh J." last="Beglinger">Leigh J. Beglinger</name><name sortKey="Gonzalez Alegre, Pedro" sort="Gonzalez Alegre, Pedro" uniqKey="Gonzalez Alegre P" first="Pedro" last="Gonzalez-Alegre">Pedro Gonzalez-Alegre</name><name sortKey="Mills, James A" sort="Mills, James A" uniqKey="Mills J" first="James A." last="Mills">James A. Mills</name><name sortKey="Nopoulos, Peggy" sort="Nopoulos, Peggy" uniqKey="Nopoulos P" first="Peggy" last="Nopoulos">Peggy Nopoulos</name><name sortKey="Paulsen, Jane S" sort="Paulsen, Jane S" uniqKey="Paulsen J" first="Jane S." last="Paulsen">Jane S. Paulsen</name><name sortKey="Paulsen, Jane S" sort="Paulsen, Jane S" uniqKey="Paulsen J" first="Jane S." last="Paulsen">Jane S. Paulsen</name><name sortKey="Prest, Luke" sort="Prest, Luke" uniqKey="Prest L" first="Luke" last="Prest">Luke Prest</name><name sortKey="Rowe, Kelly C" sort="Rowe, Kelly C" uniqKey="Rowe K" first="Kelly C." last="Rowe">Kelly C. Rowe</name><name sortKey="Smith, Megan M" sort="Smith, Megan M" uniqKey="Smith M" first="Megan M." last="Smith">Megan M. Smith</name><name sortKey="Uc, Ergun Y" sort="Uc, Ergun Y" uniqKey="Uc E" first="Ergun Y." last="Uc">Ergun Y. Uc</name><name sortKey="Uc, Ergun Y" sort="Uc, Ergun Y" uniqKey="Uc E" first="Ergun Y." last="Uc">Ergun Y. Uc</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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