Driving in Alzheimer's Disease

Dubinsky, Richard; Williamson, Annette; Gray, Carolyn Steele; Glatt, Sander L.

doi:10.1111/j.1532-5415.1992.tb01799.x

Cited by 99 publications

(67 citation statements)

References 9 publications

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“…45,46,[56][57][58] These studies may be confounded because of the failure to control for the amount of mileage actually driven, lack of control groups, small sample size, method of reporting and avoidance of high risk driving situations. [44][45][46]51,59 Overall, the evidence does support an increased risk of motor vehicle collisions in patients with dementia even with restrictions attached to driving, such as driving distance or location. 51,60-62…”

Section: Collision Ratementioning

confidence: 99%

Neurologic Conditions: Assessing Medical Fitness to Drive

Yale¹,

Hansotia²,

Knapp³

et al. 2003

Clinical Medicine & Research

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Clinicians are often asked to make an assessment on whether a patient is medically fit to drive, even though few have been formally trained in this area. Driving is a complex task that requires having adequate operational, cognitive and higher executive functions that work together. These functions can be compromised to a greater or lesser extent in neurological disorders, such as stroke, traumatic brain injury, peripheral neuropathy, dementia, Parkinson's disease and epilepsy. There is insufficient standardized information relating to impaired function at this time. Because of this, state laws vary in their assessment of medical conditions as they relate to driver licensing. Wisconsin laws are reviewed as an example. There are numerous assessment tests for various functions, but they lack a validated correlation with actual driving performance. These and other factors, as well as practical recommendations for the practicing physicians, are the subjects of this review.

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Section: Collision Ratementioning

confidence: 99%

Neurologic Conditions: Assessing Medical Fitness to Drive

Yale¹,

Hansotia²,

Knapp³

et al. 2003

Clinical Medicine & Research

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“…9,55 But, unlike our study and that of two others, 22,23 most studies have found an increased crash risk among demented drivers. [24][25][26][27][28] However, comparing the results of the different studies is difficult due to variability in study design, as well as the type and/or the severity of dementia examined. In our study, demented subjects who had ceased driving were more impaired (mean MMSE =20.7, SD=2.8) than those who continued driving (mean MMSE=25.2, SD=2.9).…”

Section: Factors Associated With Driving Cessation Onlymentioning

confidence: 99%

“…With the exception of two studies, 22,23 most investigations have reported an increased crash risk among demented drivers. [24][25][26][27][28] If attentional and executive disorders are substantial in pathological aging, they also occur to a much lesser extent, in normal aging 29,30 and may disturb driving activity. 5,6 In this study, we analyze the factors associated with driving cessation, as well as those associated with self-reported crashes.…”

Section: Introductionmentioning

confidence: 99%

Driving Cessation and Self-Reported Car Crashes in Older Drivers: The Impact of Cognitive Impairment and Dementia in a Population-Based Study

Lafont

Laumon

Helmer

et al. 2008

J Geriatr Psychiatry Neurol

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The complexity of driving activity has incited numerous developed countries to initiate evaluative procedures in the elderly, varying according to first evaluation age, frequency and screening tools. The objective of this paper is to improve the knowledge of the driving cessation process in regard to factors associated with crash involvement. Driving cessation and self-reported crashes during the past five years were analyzed with multivariate models, in a cross-sectional study including a population-based sample of 1051 drivers aged 65 years and more. Visual trouble, Parkinson disease, dementia and stroke history were associated with driving cessation. Future dementia was associated with self-reported crashes only. Attentional and executive deficits were associated with both outcomes. The detection of attentional and executive problems should be included in driving evaluation procedures in order to improve awareness of these deficits by older drivers.

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“…Studies have shown that the driver with dementia is at increased risk to cause traffic accidents. [2][3][4][5] Friedland and coworkers found a 47% prevalence rate of crashes among 30 persons with Alzheimer's disease (AD) compared to 10% of 20 age-matched controls in a retrospective survey over 5 years. 6 Overall, there is probably a 2-to 8-fold greater risk of crashes for elderly drivers with mild to moderate dementia compared to those not demented.…”

Section: Abstract Dementia; Driving; Competence; Impairmentmentioning

confidence: 99%

Driving and Dementia: A Review of the Literature

Brown

Ott

2004

J Geriatr Psychiatry Neurol

122

119

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The purpose of this article is to review the literature on the ability of individuals with dementia to drive an automobile. Based on a review of the literature, several factors were identified that may be useful in differentiating between people with dementia who presently remain safe drivers from those who have progressed to impaired driving. These factors include disease duration and severity, sex, patient self-assessment, family assessment, neuropsychological measures, findings on road evaluations, and driving simulator testing. The approach of the physician to driving and dementia is addressed, including in-office screening, referral for on-road driving assessments, and the potential for physician reporting to state agencies. Keywords dementia; driving; competence; impairmentWith the increasing age of the American population, the proportion of older drivers on the road is also rising. 1 Given that age is the most significant risk factor for developing dementia, it is apparent that large numbers of licensed drivers in North America are demented or are likely to become demented. Studies have shown that the driver with dementia is at increased risk to cause traffic accidents. [2][3][4][5] Friedland and coworkers found a 47% prevalence rate of crashes among 30 persons with Alzheimer's disease (AD) compared to 10% of 20 age-matched controls in a retrospective survey over 5 years. 6 Overall, there is probably a 2-to 8-fold greater risk of crashes for elderly drivers with mild to moderate dementia compared to those not demented. 7 A recent longitudinal study of drivers with dementia confirmed the decline of on-road driving abilities, particularly on aspects of the driving exam requiring more complex abilities such as awareness of driving environment and decision making. 8 Thus, among those who continue to drive, dementia is a well-recognized, age-related risk factor for hazardous driving. A number of editorials and review articles have addressed the issue of driving and dementia. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] There is evidence to suggest, however, that not all persons with dementia are incompetent drivers, particularly in the very early stages. [28][29][30][31][32] Given this evidence, it is particularly important to determine the most important cognitive or functional factors that contribute to driving impairment among those with dementia.

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Driving in Alzheimer's Disease

Abstract: This study suggests that a significant traffic safety problem exists in subjects with AD who continue to drive. Efforts should be directed to detect patients with AD whose driving presents a traffic safety problem.

Cited by 99 publications

References 9 publications

Neurologic Conditions: Assessing Medical Fitness to Drive

Neurologic Conditions: Assessing Medical Fitness to Drive

Driving Cessation and Self-Reported Car Crashes in Older Drivers: The Impact of Cognitive Impairment and Dementia in a Population-Based Study

Driving and Dementia: A Review of the Literature

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