Consensus Statements on Driving for Persons with Dementia

Wheatley, Carol J.; Carr, David B.

doi:10.3109/07380577.2014.903583

Cited by 20 publications

(12 citation statements)

References 28 publications

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“…The cognitive measures selected most often (for all four cases) were the Clock Drawing test, MoCA, and MMSE. Caution is warranted in using global measures such as the MoCA and MMSE alone for determining FTD (e.g., Wheatley et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Practices Used by Occupational Therapists and Others in Driving Assessment Centers for Determining Fitness-to-Drive: A Case-Based Approach

Vrkljan

Myers

Blanchard

et al. 2015

Physical & Occupational Therapy In Geriatrics

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Aims: The purpose of this study was to examine practices used in driver assessment centers for determining fitness-to-drive (FTD) an automobile using a casebased approach. Methods: Each assessor (N = 46; 89% of whom were occupational therapists) identified if and how they would assess each of the following cases: (1) a 35year-old man with paraplegia; (2) a 53-year-old woman post stroke; (3) an 82-year-old man involved in a collision; and (4) a 33-year-old woman with schizophrenia. Results: Over 90% would assess cases 2 and 3, but only 72% and 62% would assess cases 4 and 1, respectively. The average number of off-road tests they would use ranged from 1 to 24 and was highest for case 2 (14 ± 4.6) and lowest for case 1 (10.6 ± 3.4). Over 75% of respondents indicated they would do an on-road test in all four cases. Conclusions: This case-based approach provided further insight into how FTD assessments and ensuing recommendations are tailored for different clientele.

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Section: Discussionmentioning

confidence: 99%

Practices Used by Occupational Therapists and Others in Driving Assessment Centers for Determining Fitness-to-Drive: A Case-Based Approach

Vrkljan

Myers

Blanchard

et al. 2015

Physical & Occupational Therapy In Geriatrics

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“…Older adults may not know the best way to transition from driving to using other transportation because of a lack of referral pathways between doctors and driver rehabilitation specialists, inadequate education by healthcare providers to clients and their families, and a lack of public policies that promote accessible transportation alternatives for older adults. Finally, it is unclear whether family members of older adults with cognitive impairment are aware of unsafe driving or know how to address the issue of driving transition effectively …”

mentioning

confidence: 99%

Driving with Mild Cognitive Impairment or Dementia: Cognitive Test Performance and Proxy Report of Daily Life Function in Older Women

Vaughan

Hogan

Rapp

et al. 2015

J American Geriatrics Society

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OBJECTIVES To investigate associations between proxy report of cognitive and functional limitations and cognitive performance and current or former driving status in older women with mild cognitive impairment (MCI) and all-cause dementia. DESIGN Cross-sectional data analysis of retrospectively identified older women with adjudicated MCI and all-cause dementia in the Women’s Health Initiative Memory Study—Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO). SETTING Academic medical center. PARTICIPANTS Women (mean age ± standard deviation 83.7 ± 3.5) adjudicated with MCI or dementia during Year 1, 2, 3, or 4 of the WHIMS-ECHO follow-up period (N = 385). MEASUREMENTS The telephone-administered cognitive battery included tests of attention, verbal learning and memory, verbal fluency, executive function, working memory, and global cognitive function plus self-report measures of depressive symptomatology. The Dementia Questionnaire (DQ) was administered to a knowledgeable proxy (family member, friend). RESULTS Sixty percent of women with MCI and 40% of those with dementia are current drivers. Proxy reports of functional limitations in instrumental activities of daily living (IADLs) are associated with current driving status in women with MCI, whereas performance-based cognitive tests are not. In women with dementia, proxy reports of functional limitations in IADLs and performance-based cognitive tests are associated with current driving status, as expected. CONCLUSION These findings have clinical implications for the importance of evaluating driving concurrently with other instrumental functional abilities in MCI and dementia. Additional work is needed to determine whether proxy report of cognitive and functional impairments should help guide referrals for driving assessment and rehabilitation or counseling for driving transition.

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“…Unfortunately, a lack of more specific information about how they diagnosed MCI makes direct comparisons difficult with their study. It may suggest, however, that as MCI progresses, more severe driving errors will come forth (Wheatley et al, 2014; Hird et al, 2016). …”

Section: Discussionmentioning

confidence: 99%

“…For older drivers with MCI, transitioning to alternative transportations is an option that needs to be considered as driving cessation will occur in the future (Carr and Ott, 2010; Wheatley et al, 2014). Before this potential transition occurs, one approach could be to examine whether or not these individuals can be retrained to maintain or even improve their actual level of driving performance.…”

Section: Introductionmentioning

confidence: 99%

Older Adults with Mild Cognitive Impairments Show Less Driving Errors after a Multiple Sessions Simulator Training Program but Do Not Exhibit Long Term Retention

Teasdale

Simoneau

Hudon

et al. 2016

Front. Hum. Neurosci.

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The driving performance of individuals with mild cognitive impairment (MCI) is suboptimal when compared to healthy older adults. It is expected that the driving will worsen with the progression of the cognitive decline and thus, whether or not these individuals should continue to drive is a matter of debate. The aim of the study was to provide support to the claim that individuals with MCI can benefit from a training program and improve their overall driving performance in a driving simulator. Fifteen older drivers with MCI participated in five training sessions in a simulator (over a 21-day period) and in a 6-month recall session. During training, they received automated auditory feedback on their performance when an error was noted about various maneuvers known to be suboptimal in MCI individuals (for instance, weaving, omitting to indicate a lane change, to verify a blind spot, or to engage in a visual search before crossing an intersection). The number of errors was compiled for eight different maneuvers for all sessions. For the initial five sessions, a gradual and significant decrease in the number of errors was observed, indicating learning and safer driving. The level of performance, however, was not maintained at the 6-month recall session. Nevertheless, the initial learning observed opens up possibilities to undertake more regular interventions to maintain driving skills and safe driving in MCI individuals.

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Consensus Statements on Driving for Persons with Dementia

Cited by 20 publications

References 28 publications

Practices Used by Occupational Therapists and Others in Driving Assessment Centers for Determining Fitness-to-Drive: A Case-Based Approach

Practices Used by Occupational Therapists and Others in Driving Assessment Centers for Determining Fitness-to-Drive: A Case-Based Approach

Driving with Mild Cognitive Impairment or Dementia: Cognitive Test Performance and Proxy Report of Daily Life Function in Older Women

Older Adults with Mild Cognitive Impairments Show Less Driving Errors after a Multiple Sessions Simulator Training Program but Do Not Exhibit Long Term Retention

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