Driving Problems in the Elderly and Cognitively Impaired

Abstract

Driving ability in the elderly and cognitively impaired is of growing demographic relevance. Driving represents a complex task for which multiple central resources are needed. In mild cognitive impairment and dementia, we need to closely monitor driving ability, as it gets irrecoverably lost in the course of the disease. In normal aging, people are often able to self-regulate driving behavior with respect to their medical conditions. Some studies demonstrated that older drivers perform well compared with younger drivers. Others suggest a decline of driving ability in the process of normal aging and an increasing involvement of older drivers in car crashes. However, these findings have been questioned because of several possible biases. Therefore, unnecessary driving restrictions need to be avoided. The reliable evaluation of driving ability requires a specialist assessment with detailed neurocognitive evaluation, investigation of medical history and medical history by proxy, as well as on-the-the-road tests. Highlighting current knowledge in this field, we would like to increase our readers' awareness for the complexity of driving-associated challenges in an aging population.

Research on Assessing Driving Ability of Older Drivers Based on Cognitive Tests: A Case Study of Beijing, China

“…In this research, further examination of the cognitive tests revealed that memory, reaction and judgment ability were all associated with the age of the drivers because all the test scores had a significant influence between the two groups. This was also consistent with Robert's conclusion that differences in cognitive function increase with age [15].…”

“…The brief mental status examinations mainly consist of the Montreal Cognitive Assessment (MoCA) and the Mini Mental State Examination (MMSE) [10,11]. Awareness allows an individual to engage in appropriate self-monitoring while driving, and subsequently make important decisions regarding compensatory strategies [12][13][14][15][16][17].…”

Accuracy of praxis test from Cambridge Cognitive Examination (CAMCOG) for Alzheimer’s disease: a cross-sectional study

“…Although only one of the skills may be impaired, management of elderly patients with major neurocognitive disorder becomes both a problem for the family and a public health problem, in that elderly drivers should be evaluated. 29 There is a need to review the praxis items within CAMCOG, so as to be able to assess the skills of elderly drivers. Impaired driving skills are only one example of the negative debilitating effects of apraxia, but it is important to emphasize the general importance of evaluation of praxis, as one of the indicators of cognitive fragility among elderly patients.…”

‘We’re Not Doing It To Be Nasty’: Caregivers’ Ethical Dilemmas in Negotiating Driving Safety with Older Adults

“…For instance, neither Alzheimer's nor Parkinson's disease has specific time frames or markers that clearly indicate when an individual is no longer safe to drive (Hebert, Martin-Cook, Svetlik, & Weiner, 2003;Turner, Liddle, & Pachana, 2017). Accordingly, the literature on driving cessation is dominated by efforts to develop and evaluate measures of driving ability (Bennett, Chekaluk, & Batchelor, 2016;Brown & Ott, 2004;Cameron et al, 2017;Haussmann, Buthut, & Donix, 2017;Piersma et al, 2018). Off-road tests, such as the Clinical Dementia Rating Scale or the Mini-Mental State Examination, have not been found to be sufficient measures of driving performance or risk level to determine when an individual is unsafe to drive (Bennett et al, 2016;Davis & Ohman, 2017).…”