Citation

Morrow SA, Classen S, Monahan M, Danter T, Taylor R, Krasniuk S, Rosehart H, He W. Mult. Scler. 2018; 24(11): 1499-1506.

Affiliation

Department of Statistical and Actuarial Sciences, Western University, London, ON, Canada.

Copyright

(Copyright © 2018, SAGE Publishing)

DOI

10.1177/1352458517723991

PMID

28782411

Abstract

BACKGROUND: Cognitive impairment is common in multiple sclerosis (MS). In other populations, cognitive impairment is known to affect fitness-to-drive. Few studies have focused on fitness-to-drive in MS and no studies have solely focused on the influence of cognitive impairment.

OBJECTIVE: To assess fitness-to-drive in persons with MS with cognitive impairment and low physical disability.

METHODS: Persons with MS, aged 18-59 years with EDSS ⩽ 4.0, impaired processing speed, and impairment on at least one measure of memory or executive function, were recruited. Cognition was assessed using the Minimal Assessment of Cognitive Function battery. A formal on-road driving assessment was conducted. Chi-square analysis examined the association between the fitness-to-drive (pass/fail) and the neuropsychological test results (normal/impaired). Bayesian statistics predicting failure of the on-road assessment were calculated.

RESULTS: Of 36 subjects, eight (22.2%) were unfit to drive. Only the BVMTR-IR, measuring visual-spatial memory, predicted on-road driving assessment failure ( X(2) ( df = 1, N = 36) = 3.956; p = 0.047) with a sensitivity of 100%, but low specificity (35.7%) due to false positives (18/25).

CONCLUSION: In persons with MS and impaired processing speed, impairment on the BVMTR-IR should lead clinicians to address fitness-to-drive.

Language: en

Keywords

Multiple sclerosis; cognitive impairment; fitness-to-drive; processing speed; visual-spatial memory