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The impact of HIV-related neuropsychological dysfunction on driving behavior

Published online by Cambridge University Press:  01 November 1999

THOMAS D. MARCOTTE
Affiliation:
University of California at San Diego, Department of Psychiatry, San Diego, CA
ROBERT K. HEATON
Affiliation:
University of California at San Diego, Department of Psychiatry, San Diego, CA
TANYA WOLFSON
Affiliation:
University of California at San Diego, Department of Psychiatry, San Diego, CA
MICHAEL J. TAYLOR
Affiliation:
University of California at San Diego, Department of Psychiatry, San Diego, CA
OMAR ALHASSOON
Affiliation:
University of California at San Diego, Department of Psychiatry, San Diego, CA
KAIVON ARFAA
Affiliation:
University of California at San Diego, Department of Psychiatry, San Diego, CA
IGOR GRANT
Affiliation:
University of California at San Diego, Department of Psychiatry, San Diego, CA Veterans Affairs Healthcare System, San Diego, CA

Abstract

HIV infection often results in neuropsychological (NP) impairment. In order to assess the impact that HIV-related NP deficits may have on automobile driving, we evaluated 68 HIV-seropositive drivers using an NP battery and two PC-based driving simulations. Thirty-two participants were classified as NP impaired; most (72%) evidenced only mild impairment, and none met criteria for HIV-associated dementia. After controlling for degree of immunosuppression and disease stage, NP-impaired participants failed a previously validated driving simulation at a much higher rate than cognitively intact participants [OR = 5.3, 95% CI (1.7, 17.0), p = .006]. Similarly, on a simulation of city driving, NP impaired participants were more likely to fail based upon the number of accidents [OR = 6.1, 95% CI (1.5, 24.6), p = .01]. Simulator performance was predicted by functioning in a number of NP domains, with NP tests accounting for 13–30% of the variance on the simulations. Although it would be premature to extrapolate these findings to impairment in on-the-road driving, they do argue for greater attention to the impact that even mild HIV-related NP deficits may have on driving skills. (JINS, 1999, 5, 579–592.)

Type
Research Article
Copyright
© 1999 The International Neuropsychological Society

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