Using the A/T/N framework to examine driving in preclinical Alzheimer disease

The A/T/N classification system is the foundation of the 2018 National Institute on Aging (NIA)-Alzheimer’s Association Research Framework and is intended to guide the Alzheimer disease (AD) research agenda for the next 5–10 years. Participant data is classified based on the level of amyloid (A), tau (T), and neurodegeneration (N) in their brain (which is measured through cerebrospinal fluid and/or brain imaging).

Driving is a widespread functional activity that may be particularly useful in investigation of functional changes in preclinical AD before onset of cognitive symptoms. We examined driving in preclinical AD using the A/T/N framework and found that the onset of driving difficulties is most associated with abnormality of both amyloid and tau pathology, rather than amyloid alone. These results have implications for participant selection into clinical trials and for the timing of interventions aimed at prolonging the time of safe driving among older adults with preclinical AD.

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