Driving Cessation in Older Men with Incident Dementia

Abstract

Incident dementia is a major cause of driving cessation. Based on these data, we estimate that approximately 4% of male drivers aged 75 years and older nationwide (about 175,000 men) have dementia. This number will increase with the projected growth of drivers aged 75 years and older.

Predictors of driving cessation in mild-to-moderate dementia

“…COSID findings confirmed the associations previously documented of driving cessation with disease severity, increasing cognitive impairment and age. [4][5][6][7]9 These same factors have also been shown to increase the risk of motor-vehicle collisions in people with dementia. 10 Male gender has been associated with a higher risk of crashes and moving violations; 22 it is notable that at baseline, we found women to be significantly likelier than men to have already quit driving.…”

“…3 Although incidents involving drivers affected by dementia frequently make the headlines in the lay press, there is surprisingly little data on the factors in dementia that may be associated with driving cessation. In a cross-sectional study of community-dwelling subjects, Foley and colleagues 4 found that 46% of those whose dementia was rated as questionable (i.e., with a Clinical Dementia Rating 5 [CDR] of 0.5) and 22%, as mild (CDR 1) were still driving. Indeed, Duchek and associates 6 found that of patients who passed an on-road test at baseline, only about 20% of those with questionable dementia and none of those with mild dementia passed another road test 2 years later.…”

The Mini‐Mental State Examination, Clinical Factors, and Motor Vehicle Crash Risk

“…[3][4][5] Although the public priority should be to reduce risks associated with driving, imposing driving restrictions can negatively affect people by decreasing autonomy and increasing depression risk, emphasizing the need to make these decisions based on sound clinical evidence. 6 Although not specifically designed to assess driving ability, the Mini-Mental State Examination (MMSE) is one of the most widely used screening tools for cognitive dysfunction.…”

The Wechsler Digit Symbol Substitution Test as the Best Indicator of the Risk of Impaired Driving in Alzheimer Disease and Normal Aging

“…Concerning the effect of DAT on crash risk, certain studies have found a higher crash risk [18][19][20][21][22][23][24] , while others have not [25][26][27] . A higher crash risk is probably not found systematically because people suffering from DAT often limit or even stop driving altogether [19,26,28] , these restrictions increasing with the severity of the disease [29][30][31] .…”