Driving Cessation in Patients Attending a Young-Onset Dementia Clinic: A Retrospective Cohort Study

Velayudhan, Latha; Baillon, Sarah; Urbaskova, Gabriela; McCulloch, Laura; Tromans, Samuel; Storey, Mathew; Lindesay, James; Bhattacharyya, Sagnik

doi:10.1159/000488237

Cited by 8 publications

(7 citation statements)

References 38 publications

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“…Because individuals with cognitive impairment often rely on proxy report, in a sensitivity analysis we included proxy status in our model to account for the potential subjectivity of the proxy respondents and limited our analysis to nonproxy survey respondents (data not shown). The persistent protective effect of dementia status against transportation disadvantage is unexpected and warrants further investigation, in light of previous research on the relationship between dementia and driving, including the onset of driving difficulties throughout the AD trajectory and the transition to nondriving status (Brown & Ott, 2004;Roe et al, 2017;Stout et al, 2018;Velayudhan et al, 2018).…”

Section: Discussionmentioning

confidence: 86%

Driving Status and Transportation Disadvantage Among Medicare Beneficiaries

2018

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Transportation disadvantage may have important implications for the health, well-being, and quality of life of older adults. This study used the 2015 National Health Aging Trends Study, a nationally representative study of Medicare beneficiaries aged 65 and over ( N = 7,498), to generate national estimates of transportation modalities and transportation disadvantage among community-dwelling older adults in the United States. An estimated 10.8 million community-dwelling older adults in the United States rarely or never drive. Among nondrivers, 25% were classified as transportation disadvantaged, representing 2.3 million individuals. Individuals with more chronic medical conditions and those reliant on assistive devices were more likely to report having a transportation disadvantage ( p < .05). Being married resulted in a 50% decreased odds of having a transportation disadvantage ( p < .01). Some individuals may be at higher risk for transportation-related barriers to engaging in valued activities and accessing care, calling for tailored interventions such as ride-share services combined with care coordination strategies.

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Section: Discussionmentioning

confidence: 86%

Driving Status and Transportation Disadvantage Among Medicare Beneficiaries

2018

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“…This study included retrospective data of patients aged <65 years of age who were assessed at the Younger Person's Memory Service (YPMS) within the Mental Health Service for Older People at the Leicestershire Partnership National Health Service (NHS) Trust, UK, between January 2000 and December 2013, described previously [8]. Patients were referred by general practitioners from primary care and also specialists such as neurologists and general adult psychiatrists from secondary care, within Leicestershire and Rutland, East Midlands region of England.…”

Section: Methods and Subjectsmentioning

confidence: 99%

“…YPMS is a multidisciplinary team that provides assessment and management to all patients by a community psychiatric nurse, occupational therapist, psychologist, and psychiatrist [8]. The patients were assessed for cognitive functions, functional abilities, and behavioural symptoms in a 90-min semistructured interview.…”

Section: Methods and Subjectsmentioning

confidence: 99%

Predictive Factors for Conversion to Dementia in Individuals with Early-Onset Mild Cognitive Impairment

Baird

Baillon

Lau

et al. 2021

Dement Geriatr Cogn Disord

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Introduction: There is little research on factors predicting conversion to dementia in early-onset mild cognitive impairment (eoMCI), a transitional stage between healthy ageing and dementia in individuals below the age of 65. We aimed to examine whether sociodemographic and clinical factors at initial presentation predicted dementia progression in a cohort of eoMCI patients attending a memory service, at a university teaching hospital in the UK. Methods: This is a retrospective case note study of individuals diagnosed with eoMCI between 2000 and 2013 at the Younger Person’s Memory Service (YPMS) in Leicestershire, England. Data collected at assessment included social factors, demographic characteristics, and medical and psychiatric history, as well as standardized cognitive assessment scores. Variables were analysed using χ2 or independent sample t tests to identify associations. A Cox regression survival analysis was done to identify predictive factors for dementia conversion. An ROC analysis for total CAMCOG was used to investigate sensitivity and specificity for dementia converters versus non-converters. Results: Out of 531 subjects who attended YPMS, 65 patients were given a diagnosis of eoMCI (47.7% female; mean age 56.4 ± 7.54 years). Of these, 21 (32.3%) converted to dementia during their course within the service. Comparison between subgroups revealed a significant association between dementia conversion and higher years of education and lower MMSE and CAMCOG (total and subscale) scores at baseline. Smoking history, alcohol use, or medical history such as diabetes or heart disease were not associated with conversion. Cox regression survival analysis showed higher education in years and lower total CAMCOG scores were significant predictors for conversion. Lower scores on the recent memory, remote memory, learning memory, and executive function subscales of the CAMCOG were also significant predictors for conversion. ROC curve analysis for total CAMCOG demonstrated that the best detection of dementia converters can be achieved with a cutoff score of 90.5/107 (sensitivity of 76.2% and specificity of 68.2%). Area under the curve was 0.808 (95% CI: 0.697–0.920). Conclusion: More years in education and lower cognitive scores on CAMCOG at initial assessment are associated with progression to dementia from eoMCI. Further research is required to explore these predictive factors more.

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“…8 In addition to loss of occupation, patients with YOD often cease driving after diagnosis. 10 Approximately, 80% of YOD patients had a driver's licence, which is similar to LOD patients, despite LOD patients being almost twice as likely to have a diagnosis of poor vision. Although there was no difference in MIZ scores between YOD and LOD patients, the majority of participants in both groups resided in either larger centres (population ≥ 10,000) or rural areas with a weak MIZ where a small fraction of workers commute to larger centre.…”

Section: Health Education and Employmentmentioning

confidence: 99%

“…8 As a consequence of job loss, YOD patients have unmet needs in daytime activities and social company. 3,9 Patients with YOD often stop driving, 10 which further results in the loss of freedom and independence.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Young-Onset and Late-Onset Dementia Patients at a Remote Memory Clinic

Wong

Kirk

Perlett

et al. 2020

Can. J. Neurol. Sci.

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ABSTRACT:Background:Young-onset dementia (YOD) is defined as the onset of dementia symptoms before the age of 65 years and accounts for 2–8% of dementia. YOD patients and their caregivers face unique challenges in diagnosis and management. We aimed to compare the characteristics of rural YOD and late-onset dementia (LOD) patients at a rural and remote memory clinic in Western Canada.Methods:A total of 333 consecutive patients (YOD = 61, LOD = 272) at a rural and remote memory clinic between March 2004 and July 2016 were included in this study. Each patient had neuropsychological assessment. Health, mood, function, behaviour and social factors were also measured. Both groups were compared using χ2 tests and independent sample tests.Results:YOD patients were more likely to be married, employed, current smokers and highly educated. They reported fewer cognitive symptoms, but had more depressive symptoms. YOD patients were less likely to live alone and use homecare services. YOD caregivers were also more likely to be a spouse and had higher levels of distress than LOD caregivers. Both YOD and LOD patient groups were equally likely to have a driver’s licence.Conclusions:Our findings indicate YOD and LOD patients have distinct characteristics and services must be modified to better meet YOD patient needs. In particular, the use of homecare services and caregiver support may alleviate the higher levels of distress found in YOD patients and their caregivers. Additional research should be directed to addressing YOD patient depression, caregiver distress and barriers to services.

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Driving Cessation in Patients Attending a Young-Onset Dementia Clinic: A Retrospective Cohort Study

Cited by 8 publications

References 38 publications

Driving Status and Transportation Disadvantage Among Medicare Beneficiaries

Driving Status and Transportation Disadvantage Among Medicare Beneficiaries

Predictive Factors for Conversion to Dementia in Individuals with Early-Onset Mild Cognitive Impairment

Characteristics of Young-Onset and Late-Onset Dementia Patients at a Remote Memory Clinic

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