It is unclear at what stage of Alzheimer disease (AD) older adults stop driving and whether preclinical AD affects driving cessation. We looked at AD cerebrospinal fluid (CSF) biomarkers, a rating of dementia severity, and how many years it took for participants to stop driving. We examined 1795 older adults, who were followed up to 24 years. A subset of 591 participants had CSF biomarker measurements and were followed up to 17 years. Higher dementia severity scores and higher levels of AD biomarkers, including among individuals with preclinical AD (no memory issues), lead to earlier driving cessation. These types of negative functional outcomes show that just because the full symptoms of AD have not begun, preclinical AD is not a benign phase of the disease.
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