Cognitive impairment and driving: A review of the literature

Apolinário, Daniel; Magaldi, Regina Miksian; Lopes, Leonardo da Costa; Kasai, Juliana Yumi Tison; Satomi, Érika

doi:10.1590/s1980-57642009dn30400004

Cited by 35 publications

(20 citation statements)

References 49 publications

(57 reference statements)

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“…"Mode of transportation" is an item to ask whether patients with AD can drive a car or use public transportation. Apolinario et al [27] reported that visuospatial cognition was most strongly associated with driving ability. The results of this study suggest that car driving and public transport use in patients with AD may require visual-spatial cognition.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Performance on the Mini-Mental State Examination Sub-Items and Activities of Daily Living in Patients with Alzheimer’s Disease

Han

Maruta

Ikeda

et al. 2020

JCM

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Mini-mental state examination (MMSE) subitems provide useful information about the cognitive status of patients with Alzheimer’s disease (AD). If the relationship between MMSE subitems and activities of daily living (ADL) can be shown, the performance of sub-items can predict ADL status and may provide useful information for early ADL intervention. Therefore, the purpose of this study was to investigate the relationship between MMSE subitem scores and ADL. The study sample consisted of 718 patients with AD. Logistic regression analysis using the Physical Self-maintenance Scale (PSMS) and Lawton’s Instrumental ADL (L-IADL) was performed with each of the subitems as the dependent variables and the MMSE subitem as the independent variable. As a result, the subitems of MMSE, which are strongly related to each item in PSMS differed (e.g., toilet: registration odds ratio 3.00, grooming: naming 3.66). In the case of L-IADL, most items were strongly associated with “writing” (e.g., shopping: odds ratio 4.29, laundry 3.83). In clinical practice, we often focus only on the total MMSE score in patients with AD. However, the relationship between each MMSE subitem and ADL suggested in this study may be useful information that can be linked to ADL care from the performance of the MMSE subitem.

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Section: Discussionmentioning

confidence: 99%

Relationship between Performance on the Mini-Mental State Examination Sub-Items and Activities of Daily Living in Patients with Alzheimer’s Disease

Han

Maruta

Ikeda

et al. 2020

JCM

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“…Driving is a complex task that requires a range of cognitive skills (such as attention and executive functions), visuospatial skills, motor ability, and multisensory perception (95,96).…”

Section: Screening Tools Neuropsychological Assessments and Cognitive Domainsmentioning

confidence: 99%

The Effects of Opioids on Cognition in Older Adults With Cancer and Chronic Noncancer Pain: A Systematic Review

Pask¹,

Dell'Olio²,

Murtagh³

et al. 2020

Journal of Pain and Symptom Management

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Opioids are prescribed to manage moderate to severe pain and can be used with older adults; however, they may lead to several adverse effects, including cognitive impairment. ObjectiveTo identify, appraise and synthesise evidence on i) the impact of opioids on cognition in older adults with cancer/chronic non-cancer pain, and ii) screening tools/neuropsychological assessments used to detect opioid-induced cognitive impairment. MethodsA systematic literature review following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PROSPERO Registration CRD42018092943). MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library and Web of Science were searched up to ConclusionBoth improvements and impairments to cognition were observed in studies with higher mean opioid doses. In clinical practice, a brief screening tool assessing attention, language, orientation, psychomotor function, and verbal working/delayed episodic memory, may be beneficial to detect worsening cognition in older adults with chronic pain using opioids.

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“…All subjects were asked to complete the Patient Health Questionnaire-9 (PHQ-9) and Montreal Cognitive Assessment (MoCA) since major depression or previously undiagnosed severe cognitive impairment may have an impact on driving ability. [7,8] Patients" driving habits were then assessed with the Driving Habits Questionnaire (DHQ) before the driving simulation.…”

Section: Protocolmentioning

confidence: 99%

Driving Habits and Reaction Times on a Driving Simulation in Older Drivers With Chronic Heart Failure

Pan

Pellicori

Walklett

et al. 2020

Journal of Cardiac Failure

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Background: Judgement and reaction times during complex tasks like driving may be impaired in older adults with chronic heart failure (HF).Objectives: This study sought to report the driving habits and reaction times of older patients with HF in a specially designed urban driving simulation. Methods:We conducted a prospective observational study in HF patients and controls.Patients in both groups underwent cognitive testing and screening for depression. Current drivers undertook questionnaire regarding driving habits followed by an urban road driving simulation consisting of three laps. Five separate hazards appeared in the third lap without warning. Reaction times and stopping distances to the hazards were calculated. Results: Of 247 patients with HF approached for the study, 124 had already voluntarily stopped driving due to HF (n=92) or other medical conditions (n=32), 60 had never had a license, and 32 declined to participate. Of the 74 controls approached, 1 was not currently driving due to a medical condition, and 46 declined to participate. Patients in both groups had similar levels of cognitive function, mood and driving habits. 30 patients with HF [mean (SD) age 74 (±5) years, median (IQR) NT-proBNP 1510 (546-3084) pg/L] and 26 controls [mean age 73 (±5) years, median NT-proBNP 135 (73-182) pg/L] completed the simulation. During lap 3, there was no difference in the driving speed between patients (mean 22.0 SD 4.5 mph) and controls (mean 21.7 SD3.3 mph; p=0.80). Patients had longer reaction times [median 1.10 (IQR 0.98-1.30) seconds) than controls [median 0.96 (IQR 0.83-1.10) seconds, p=0.02], but there was no difference in stopping distances [patients: median 43.9 (IQR 32.2-49.5) metres; controls: median 38.1 (IQR 32.3-48.8) metres, p=0.31)].

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Cognitive impairment and driving: A review of the literature

Cited by 35 publications

References 49 publications

Relationship between Performance on the Mini-Mental State Examination Sub-Items and Activities of Daily Living in Patients with Alzheimer’s Disease

Relationship between Performance on the Mini-Mental State Examination Sub-Items and Activities of Daily Living in Patients with Alzheimer’s Disease

The Effects of Opioids on Cognition in Older Adults With Cancer and Chronic Noncancer Pain: A Systematic Review

Driving Habits and Reaction Times on a Driving Simulation in Older Drivers With Chronic Heart Failure

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