Olfactory discrimination and identification as prognostic markers of fitness-to-drive in older drivers.

The necessity for reliable, standardized and validated fitness to drive assessment tools for older drivers have been highlighted and discussed for over three decades. Existing neuropsychological tests of driving performance are focusing mostly on visuo-spatial attention and executive functioning rather than other senses. Over the last decade, olfactory deterioration has been found to be associated with cognitive decline and predicting transition from mild cognitive impairment to dementia. The AGILE fitness to drive battery is standardized for older drivers. In this study it was adapted to include the olfactory Sniff' and Stick's test. The aim was to investigate the value of relevant deficits as predictive markers of driving ability in three driving groups (older drivers with: (a) no impairment (controls), (b) with Mild Cognitive Impairment (MCI) and (c) MCI and other chronic conditions, i.e., comorbidities). So far, no other study has investigated the predictive value of olfactory deficits in driving ability. The findings revealed that discrimination is important for the first year of the examination and as the decline progresses, identification becomes the better olfactory marker. The latter is also evident in the literature. Hence, the results showed that less indicators are required compared to the initial battery. The olfactory markers were dominant over the neuropsychological tests, apart from alertness, for predicting the older driver's fitness to drive regardless of the presence of cognitive impairment and other chronic conditions.

Olfactory Decline in Older Adults with Mild Cognitive Impairment with and without Comorbidities.

Over the past two decades, several studies have measured olfactory performance in Mild Cognitive Impairment (MCI). Deficits are observed in multiple olfactory domains, including odour detection threshold, identification, discrimination, and memory. In this study, the psychophysiological Sniffin' Sticks smell screening test was administered to examine olfactory functioning in 145 older adults with MCI, a group with MCI and chronic comorbid conditions, and a healthy age-matched comparison group. We hypothesised that olfactory performance will deteriorate in the two MCI groups compared to the control group, even after assessing the known contributions of age and gender. The higher olfactory deterioration in the group with the MCI and the comorbidities in the first year disappeared in the second. This could mean that early consideration of the potential effect of other comorbidities that might affect olfaction should be taken and addressed, as they could easily mask the effect of cognitive decline and/or contribute to it. This study also found higher deterioration in smell identification in participants with MCI, as has been found repeatedly in similar research. Olfactory identification seems to be a more robust marker for discriminating people with MCI and without, and even discriminating between those with MCI and having other health problems.

ICT services for prolonging independent living of the elderly with cognitive impairments - IN LIFE concept.

Older people with cognitive impairment need support in their everyday living. IN LIFE an EC co-funded project aims to organize large-scale and multi-country pilot applications, by providing interoperable, open, personalised and seamless ICT solutions that support older persons in all key home activities, communication, health maintenance, travel, mobility and socialisation tasks, with novel, scalable and viable business models.

Is naturalistic driving research possible with highly instrumented cars? Lessons learnt in three research centres.

This paper provides an overview of the experiences using Highly Instrumented Cars (HICs) in three research Centres across Europe; Spain, the UK and Greece. The data collection capability of each car is described and an overview presented relating to the relationship between the level of instrumentation and the research possible. A discussion then follows which considers the advantages and disadvantages of using HICs for ND research. This includes the obtrusive nature of the data collection equipment, the cost of equipping the vehicles with sophisticated Data Acquisition Systems (DAS) and the challenges for data storage and analysis particularly with respect to video data. It is concluded that the use of HICs substantially increases the depth of knowledge relating to the driver's behaviour and their interaction with the vehicle and surroundings. With careful study design and integration into larger studies with Low(ly) instrumented Cars (LICs), HICs can contribute significantly and in a relatively naturalistic manner to the driver behaviour research.

[Determination of blood/serum ratios of different forensically relevant analytes in authentic samples]. / Bestimmung der Blut/Serum-verhältnisse verschiedener forensisch relevanter Analyten in authentischen Proben.

For forensic toxicological investigations only whole blood, but no serum is often available. Pharmacokinetic data are helpful for interpreting the results, but most of these studies indicate serum or plasma concentrations. In order to obtain reliable conversion factors which also take intersubject variability into account, the blood/serum ratios (B/S) of oxycodone, morphine, fentanyl, hydromorphone, zopiclone, MDMA, dexamphetamine, alprazolam, risperidone and 9-hydroxyrisperidone were determined by LC-MS/MS using authentic samples. Blood and corresponding serum samples were obtained from driving studies performed with controlled or known dosages of the above drugs. The analytes were analysed in blood and serum and the following mean B/S ratios (relative standard deviations) were determined: oxycodone 1.48 (8.19 %); morphine 1.03 (3.59 %); fentanyl 0.87 (13.9 %); hydromorphone 1.04 (8.11 %); zopiclone 0.89 (16.1 %); MDMA 1.19 (8.04 %); dexamphetamine 0.89 (10.9 %); alprazolam 0.81 (5.84 %); risperidone 0.65 (7.52 %); 9-hydroxyrisperidone 0.73 (12.3 %). These mean values are largely in line with those reported in the literature. The B/S ratios did not appear to depend on partition coefficients, whereas there was strong evidence that B/S ratios decreased with increasing plasma protein binding.