A comparison of driving in older subjects with and without age-related macular degeneration.

OBJECTIVE: To determine the effects of age and central vision loss on driving skills. METHODS: Ten subjects with age-related macular degeneration and average binocular visual acuity of 20/70, and 11 age-similar subjects with normal vision, were examined with a battery of cognitive and visual tests, an interactive driving simulator, and an on-road driving test. Data were collected on the frequency of real-world accidents and convictions for traffic violations. RESULTS: There were no significant differences between the two groups on any of the cognitive tests. The age-related macular degeneration group demonstrated poorer performance on the driving simulator, including delayed braking response times to stop signs, slower speeds, and more of both lane boundary crossings and simulator accidents. The age-related macular degeneration group also demonstrated poorer overall on-road test performance, including having significantly more points deducted for driving too slowly and for not maintaining proper lane position. However, these effects on the simulator and the on-road test did not translate into an increased risk of real-world accidents for the age-related macular degeneration group. Significantly more control subjects than patients with age-related macular degeneration were involved in self-reported accidents, and significantly more control subjects had state convictions for traffic violations. There was evidence of compensation in the age-related macular degeneration group in four major areas: (1) not driving in unfamiliar areas; (2) traveling at slow speeds; (3) self-restricting their nighttime driving, and (4) taking fewer risks while driving (eg, not changing lanes). There was also evidence of compensation in the older control group. CONCLUSIONS: Vision, simulator, and on-road test variables combined with subjective risk taking predicted self-reported real-world accidents in a logistic regression analysis. However, risk taking, rather than simulator or road-test performance, was the most significant predictor for both patients with age-related macular degeneration and the control group.

The relationship between EEG changes and cognitive functions in dementia: a study in a VA population.

This study explores the relationship between the results of tests of dementia and the EEG findings in 94 demented patients of different etiologies. Abnormal EEGs were found in 83% of all patients, usually diffuse slow wave abnormalities, the degree of which correlated very well with the Modified Hachinski test. Only a weak relationship was found between the EEG and the Mini-Mental Status Examination, while the Mattis and its subtests correlated better. Focal EEG abnormalities on the temporal areas were the characteristic pattern in patients with alcoholic dementia. The test scores in the 17% with normal EEGs were consistent with the above findings, in that patients with normal tracings scored well on the Modified Hachinski and Mattis tests, but not on the Mini-Mental Status Exam.