Driving Cessation and Cognitive Dysfunction in Patients with Mild Cognitive Impairment

Abstract

Although driving by adults with cognitive impairment is an important public health concern, little is known about the indicators of driving cessation in patients with mild cognitive impairment (MCI). We aimed to investigate the prevalence of driving cessation in patients with MCI and the predictive value of cognitive performances for driving cessation. Patients with MCI were recruited in the Seoul National University Bundang Hospital; they met following inclusion criteria. Age range of 51–80 years, Clinical Dementia Rating scale score of 0.5, and ever car drivers including former and current drivers. All participants underwent comprehensive standardized cognitive assessments and information on driving status was obtained via an interview using a systematic questionnaire. The median age of the 135 participants was 72 years, and 54 participants (40%) were women; 93 patients (68.9%) were current drivers and 42 (31.1%) were former drivers. In univariate analysis, former drivers showed poorer performances in digit span backward and categorical fluency tests than current drivers. In multivariate logistic regression analysis, a poor digit span backward test score was significantly related with driving cessation (odds ratio: 0.493, 95% confidence interval: 0.258–0.939). In patients with MCI, poor performance in the digit span backward test, which represents impaired working memory capacity, was associated with a higher probability of driving cessation.

Driving Performance and Its Correlation with Neuropsychological Tests in Senior Drivers with Cognitive Impairment in Japan

“…In our sample, younger people, males, and those with longer driving experience were more likely to be current drivers, in the light of demographic and driving-related characteristics. A similar pattern emerged in several previous studies [49][50][51]. As expected, current drivers performed better in neuropsychological testing than retired ones, which is in agreement with the findings of Vaughan et al [52].…”

Assessment of cognitive screening tests as predictors of driving cessation: A prospective cohort study of a median 4-year follow-up

“…The results of the study show an association between low performance on the baseline tests of the MoCA, UFOV, CDT and TMT and a relatively higher risk of driving cessation prospectively. Recent studies show the importance of working memory and other cognitive functions, as patients with MCI have a higher prevalence of driving cessation [33]. Poor performance on diagnostic tests, such as the digit span backward test, has been shown to be associated with prospective driving cessation (OR: 0.493, 95% CI: 0.258-0.939) [33], although other tests, such as the MMSE, have not shown a significant effect [34].…”

Lacking Pace but Not Precision: Age-Related Information Processing Changes in Response to a Dynamic Attentional Control Task

“…This is likely true up to a point, or certain age; after which it may no longer be appropriate for older adults to engage in driving behaviour that is more "resource intensive" (such as driving on motorways or at night, which requires higher speeds and increased vigilance). Although the correlation between MoCA score and STAC performance (spm) may provide some insight into how well an individual can manage these demands, it may be more appropriate if lower scores were used to prompt more in-depth cognitive assessment, such as use of STAC, to assess driving behaviour [16,20,32,38,41], particularly as driving cessation is widely considered to be a major life transition, and can have a significant impact on the health and well-being of older drivers [39,40].…”

“…Examining RT in isolation from the integrity of attentional control, and thus the above-mentioned functions, may lead to the under-or over-estimation of an individual's functional ability; a factor which may be of particular relevance to the assessment of driving ability [32] as this behaviour is highly dependent upon the integrity of attentional control components such as selective attention, attentional switching, and the inhibition of irrelevant visual information [33][34][35][36][37]. As driving cessation is widely considered to be a major life transition which can have a significant impact on the health and well-being of older drivers [38][39][40], it is vital that such ability is assessed appropriately [32,38,41].…”