Pedigo Backup

Pat & Dennis Bender Early Dementia Diagnosis & Prognosis Fund

 

J. Dennis Bender

Office, Home & Cell Phone: 859-391-5226

5726 La Jolla Blvd. – Suite 311

La Jolla, CA 92037-7345

&

Office - 100 Riverside Pl. - Suite 303

Covington, KY 41011-5711

 

 We support the development of improved diagnostic methods for the early detection and diagnosis of MCI, Alzheimer’s, vascular and other dementias, their likely prognosis, and best treatment options. We focus on the development of Bayesian-based, medical-decision-support systems, comparative-effectiveness research, and the better utilization of these for the above. (After incorporating in KY as a 501(c)3 in 2002, we dissolved that entity in favor of a simplified form of two entirely self-financed, private philanthropies utilizing a Vanguard Charitable Trust for making annual-research-grants for early-dementia-detection and its correct differential-diagnosis and likely-prognosis. They will continue on, after I am long gone, either mentally or physically, with annual grants. Scripps Foundation, Profs. Randall Bateman, James Brewer and others will be our fund’s future research grant advisors. KMK Law is our legal advisor and David J. Bender is my Estate Rep. (See: https://www.alz.org/alzheimers-dementia/research_progress/earlier-diagnosis)

 

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www.JDBender.com – EMS/eVTOL & Educational Experimental Aviation Fund (Vanguard Charitable Trust)

www.JDBender.org – Dementia Diagnosis Fund (Vanguard Charitable Trust)

 

May 23, 2024

 

 

My Pedego Fat-Tire Trike is my current backup for my C8-Z51 HTC Corvette. Having recently passed Bick’s Driving School’s comprehensive driving, cognitive & reflex’s test, it confirms that while I may have “amnestic-MCI of mixed-etiologies,” I can still safely drive my Vette.

 

“If risk is identified early, there is more time to support the remaining capacity and skills, extending the time they can drive safely, and to plan for a transition to alternative transportation options to maintain their independence when the time comes to stop driving. . . People who stop-driving are more-likely to develop depression and become isolated.”

My Tags: routine-cognitive-testing, impaired-cognitive-function, cognitive-changes, cognitive-testing, subjective-cognitive-decline, older-drivers, screening, older-patients, adults-over-age-65, alternative-transportation-options, slower-reaction-time, impaired-vision, cognitive-decline, risk-of-crashes, giving-up-driving, driving-cessation, . . . [My years of using hyphenating to ID key-tags in all my old documents has now been obsoleted by new keyword search routines and AI capabilities. Here is my last example of what I have been doing for decades with the now over 9,000+ documents in my just my dementia research files.]

Crazed Dr. Redington, my old PCP in Cincinnati, threatened to “have my driver’s-license revoked if I did not take the half-day-long driving-test at Bick’s Driving School” [ http://bickscolerain.com/ ] for $365 after previously having me do a two-hour, very-thorough, test-drive with my old dear friend Ben McAllister in Cincinnati and have him personally report the results back to Dr. Strangelove. (I passed that test with only one suggestion that I had “signaled too soon before the freeway-exit.” My test-certificate and results are available to anyone interested in seeing them at Bick’s.)

3 factors predicted who would stop-driving during the study: cognitive-impairment, worsening-PACC-scores, and being-a-woman. People who met the criteria for cognitive-impairment by scoring 0.5-or-greater on the CDR were 3.5 times more likely to stop driving than were those who remained at zero, and people with lower scores on the PACC were 30% more likely to stop driving than were those with higher scores. Age and the presence of biomarkers of Alzheimer’s-disease were not tied to the decision to stop-driving. The biggest effect was seen regarding gender, with women 4-times more-likely to stop-driving during the course of the study than men were, no surprise.

Subtle Cognitive Decline Precedes End To Driving For Older Adults

Routine Cognitive Testing May Help Older Drivers Plan For Life After Driving

by Tamara Schneider May 22, 2024

Even slight cognitive changes can affect an older person’s decision to stop driving, according to a new study by researchers at Washington University School of Medicine in St. Louis. The findings suggest that routine-cognitive-testing — in particular, the kind of screening designed to pick up the earliest, most-subtle decline — could help older-adults and their physicians make decisions about driving that maximizes safety while preserving independence as long as possible.

One of the thorniest decisions facing older adults is when to give up their keys and stop driving. A new study by researchers at Washington University School of Medicine in St. Louis could provide guidance in helping seniors plan ahead. The researchers found that impaired-cognitive-function foreshadows the decision for many seniors to stop-driving — more so than age or molecular signs of Alzheimer’s-disease. Even very-slight-cognitive-changes are a sign that retirement from driving is imminent. Further, women are more-likely to stop driving than men, the study showed.

The findings suggest that routine-cognitive-testing — in particular, the kind of screening designed to pick-up the earliest, most subtle decline — could help older adults and their physicians make decisions about driving to maximize safety while preserving independence as long as possible.

“Many older-drivers are aware of changes occurring as they age, including subjective-cognitive-decline,” said corresponding author Ganesh M. Babulal, PhD, OTD, an Associate Professor of Neurology. “Doctors should discuss such changes with their older-patients. If risk is identified early, there is more time to support the remaining capacity and skills, extending the time they can drive safely, and to plan for a transition to alternative-transportation-options to maintain their independence when the time comes to stop driving.”

The study is published May 22 online in Neurology, the medical journal of the American Academy of Neurology.

Adults-over-age-65 are the most careful drivers on the road. They are less-likely than drivers in any other age-group to speed or to drive in bad weather, at night or under the influence of substances. Despite these precautions, age-related-changes such as slower-reaction-time, impaired-vision and cognitive-decline still put older-drivers at risk-of-crashes, and when such crashes happen, older-drivers are more-likely to be killed or seriously injured than younger-drivers are. At the same time, giving-up-driving is not without its own risks. People who stop-driving are more-likely to develop depression and become isolated.

The American Academy of Neurology concluded in 2010 that cognitive impairment, as measured by a score-greater-than-zero on the Clinical Dementia Rating (CDR) scale, was the best-predictor of stopping-driving. The CDR-scale goes from 0, indicating normal-cognitive-function, to 3, indicating severe-dementia. But the CDR, which was developed at Washington University in 1982, is designed to detect impairments significant enough to affect daily-life. Studies have shown that a person’s cognitive-skills can deteriorate for years before a CDR-score indicates trouble.

Babulal and colleagues set out to determine the role of other factors, including subtle-cognitive-changes, in the decision to step-away from the wheel. They studied 283 people with an average-age-of-72 who drove-at-least-once-a-week and who had no-cognitive-impairments at the start of the study. The researchers were primarily interested in determining when and why each participant stopped-driving.

The participants underwent cognitive-tests at the start and then every-year for an average of 5.6-years. The cognitive-testing included the CDR and a preclinical Alzheimer’s cognitive composite (PACC) score, which is designed to detect subtle-cognitive-changes in people who score as unimpaired on the CDR. The participants also underwent brain-scans and donated cerebrospinal-fluid at the start of the study and then every 2-to-3-years, so the researchers could look for molecular-signs-of-Alzheimer’s-disease. At baseline, about one-third of the people met the criteria for preclinical-Alzheimer’s-disease based on levels-of-biomarkers for the disease — amyloid-plaques and tau-tangles — in the brain and cerebrospinal-fluid.

During the study, 24 people stopped-driving, 15 people died, and 46 people developed cognitive-impairment as measured by a CDR-score-greater-than-zero.

Analysis showed that 3 factors predicted who would stop-driving during the study: cognitive-impairment, worsening-PACC-scores, and being-a-woman. People who met the criteria for cognitive-impairment by scoring 0.5-or-greater on the CDR were 3.5 times more likely to stop driving than were those who remained at zero, and people with lower scores on the PACC were 30% more likely to stop driving than were those with higher scores. Age and the presence of biomarkers of Alzheimer’s-disease were not tied to the decision to stop-driving.

The biggest effect was seen regarding gender, with women 4-times more-likely to stop-driving during the course of the study than men were.

“We know from past studies that there isn’t a difference in driving-ability between men and women,” Babulal said. “What we have shown in prior work is that women are often more-aware of their abilities, are more-willing to admit that they are no longer able to safely drive, and plan more in advance to transition out of driving compared to their male counterparts. It is highly-recommended that older-male-drivers talk with their providers about driving and consider stopping driving earlier.”

Doctors do not routinely counsel older-patients on driving-cessation, a fact that Babulal sees as a missed opportunity to promote healthy aging.

“There are things we can do to help people adapt to age-related changes,” Babulal said. “Driver-rehabilitation-programs, often led by occupational-therapists, can provide specialized training and strategies for older-drivers to adjust to physical and cognitive changes to maintain-driving-capacity. Community-support-programs provide a forum for older-adults to share experiences and learn from each other about safe-driving-practices and alternative-transportation-options. Ultimately, most-people will need to stop-driving, but by starting the conversation early, we can better support older-adults’ independence and quality-of-life.”

Babulal GM, Chen L, Murphy SA, Carr DB, Morris JC. Predicting Driving Cessation Among Cognitively Normal Older Drivers. Neurology. May 22, 2024. DOI: 10.1212/WNL.0000000000209426

This study was supported by the National Institute on Aging of the National Institutes of Health (NIH), through support for the DRIVES Project, grant numbers R01AG068183, R01AG067428 and R01AG074302, and the Charles F. and Joanne Knight Alzheimer Disease Research Center, grant numbers P30 AG066444, P01AG003991 and P01AG026276. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH).

About Washington University School of Medicine

WashU Medicine is a global leader in academic medicine, including biomedical research, patient care and educational programs with 2,900 faculty. Its National Institutes of Health (NIH) research funding portfolio is the second largest among U.S. medical schools and has grown 56% in the last seven years. Together with institutional investment, WashU Medicine commits well over $1 billion annually to basic and clinical research innovation and training. Its faculty practice is consistently within the top five in the country, with more than 1,900 faculty physicians practicing at 130 locations and who are also the medical staffs of Barnes-Jewish and St. Louis Children’s hospitals of BJC HealthCare. WashU Medicine has a storied history in MD/PhD training, recently dedicated $100 million to scholarships and curriculum renewal for its medical students, and is home to top-notch training programs in every medical subspecialty as well as physical therapy, occupational therapy, and audiology and communications sciences.

Media Contact - Jessica Church - Director of Media Relations - 314-320-8485 - This email address is being protected from spambots. You need JavaScript enabled to view it.

Writer - Tamara Schneider - Senior Medical Science Writer - 314-286-0122 - This email address is being protected from spambots. You need JavaScript enabled to view it.

Tamara covers infectious diseases, molecular microbiology, neurology, neuroscience, surgery, the Institute for Informatics, the Division of Physician-Scientists and the MSTP program. She holds a double bachelor's degree in molecular biophysics & biochemistry and in sociology from Yale University, a master's in public health from the University of California, Berkeley, and a PhD in biomedical science from the University of California, San Diego. She joined WashU Medicine Marketing & Communications in 2016. She has received three Robert G. Fenley writing awards from the American Association of Medical Colleges: a bronze in 2020 for "Mind’s quality control center found in long-ignored brain area," a silver in 2022 for "Mice with hallucination-like behaviors reveal insight into psychotic illness," and a bronze in 2023 for "Race of people given Alzheimer’s blood tests may affect interpretation of results."

{Pedego Backup}