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Fahrtauglichkeit bei Patienten mit frontotemporaler und Alzheimer-Demenz

Car driving ability of patients with frontotemporal lobar degeneration and Alzheimer’s disease

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Zusammenfassung

Hintergrund

In folgender Studie werden die bei Patienten mit Alzheimer-Demenz (AD) und Demenz bei frontotemporaler Lobärdegeneration (FTLD) auftretenden Veränderungen im Fahrverhalten untersucht.

Patienten und Methoden

Mittels standardisierter Interviews wurden 56 Angehörige von Patienten mit AD (n=26) und FTLD (n=30) zu potenziellen Veränderungen im Fahrverhalten befragt.

Ergebnisse

Veränderungen in ihrem Fahrverhalten hatten 90% der Patienten mit FTLD und 58% der Patienten mit AD gezeigt. Bei den Patienten mit AD fielen in erster Linie zunehmende Schwierigkeiten auf, sich zu orientieren. Die Patienten mit FTLD zeigten hingegen einen aggressiven, risikofreudigen Fahrstil mit auffällig häufigen Übertretungen der Verkehrsregeln. Signifikante Unterschiede zwischen den beiden Gruppen ergaben sich bezüglich Geschwindigkeitsübertretungen, Missachtung roter Ampeln, inadäquater Verhaltensweisen und Fahren trotz Verbot durch die Familie. 37% der Patienten mit FTLD hatten seit Beginn der Erkrankung einen Unfall verschuldet, verglichen mit 19% der Patienten mit AD (p=0,24). Während die meisten der Patienten mit AD sich einsichtig hinsichtlich ihres veränderten Fahrverhaltens zeigten, sah der Großteil der Patienten mit FTLD nicht ein, das Autofahren aufzugeben (p=0,023).

Schlussfolgerung

Patienten mit FTLD sollten frühestmöglich im Krankheitsverlauf das Autofahren einstellen. Bei Patienten mit leichtgradiger AD muss individuell abgewogen werden.

Summary

Background

The following study presents in detail newly occurring changes in driving ability of patients with Alzheimer’s disease (AD) and dementia due to frontotemporal lobar degeneration (FTLD).

Patients and methods

The caregivers of 30 patients with FTLD (20 with FTD, 10 with SD) and 26 matched patients with AD were interviewed on potential alterations in driving ability using a standardized questionnaire.

Results

Of the patients 90% with FTLD and 58% with AD showed changes in driving behavior. In AD the predominating alteration was an unsteady style of driving with increased lack of orientation. Patients with FTLD presented an aggressive and risky style of driving including various traffic rule violations. Significant differences between the two groups were observed regarding speeding, disregarding red traffic lights, inappropriate behavior and driving despite being forbidden by the family Of the patients with FTLD 37% were responsible for at least one accident since disease onset in comparison to 19% of patients with AD (p=0.24). Most patients with AD showed a reasonable attitude to their change in driving behavior, however the majority of patients with FTLD showed a lack of understanding for the fact that their style of driving presented a potential risk and did not accept the need to stop driving (p=0.023).

Conclusion

Patients with FTLD should cease driving as soon as possible in the course of the disease. With patients suffering from mild AD an individual assessment should be made.

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Authors and Affiliations

  1. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität, Ismaninger Straße 22, 81675, München, Deutschland

    J. Ernst, S. Krapp, H. Förstl, A. Kurz & J. Diehl-Schmid

  2. Institut für Medizinische Statistik und Epidemiologie der TU München, München, Deutschland

    T. Schuster

Authors
  1. J. Ernst
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  2. S. Krapp
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  3. T. Schuster
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  4. H. Förstl
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  5. A. Kurz
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  6. J. Diehl-Schmid
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Corresponding author

Correspondence to J. Ernst.

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Ernst, J., Krapp, S., Schuster, T. et al. Fahrtauglichkeit bei Patienten mit frontotemporaler und Alzheimer-Demenz. Nervenarzt 81, 79–85 (2010). https://doi.org/10.1007/s00115-009-2847-5

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  • DOI: https://doi.org/10.1007/s00115-009-2847-5

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