Driving with Mild Cognitive Impairment or Dementia: Cognitive Test Performance and Proxy Report of Daily Life Function in Older Women

Abstract

OBJECTIVES To investigate associations between proxy report of cognitive and functional limitations and cognitive performance and current or former driving status in older women with mild cognitive impairment (MCI) and all-cause dementia. DESIGN Cross-sectional data analysis of retrospectively identified older women with adjudicated MCI and all-cause dementia in the Women’s Health Initiative Memory Study—Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO). SETTING Academic medical center. PARTICIPANTS Women (mean age ± standard deviation 83.7 ± 3.5) adjudicated with MCI or dementia during Year 1, 2, 3, or 4 of the WHIMS-ECHO follow-up period (N = 385). MEASUREMENTS The telephone-administered cognitive battery included tests of attention, verbal learning and memory, verbal fluency, executive function, working memory, and global cognitive function plus self-report measures of depressive symptomatology. The Dementia Questionnaire (DQ) was administered to a knowledgeable proxy (family member, friend). RESULTS Sixty percent of women with MCI and 40% of those with dementia are current drivers. Proxy reports of functional limitations in instrumental activities of daily living (IADLs) are associated with current driving status in women with MCI, whereas performance-based cognitive tests are not. In women with dementia, proxy reports of functional limitations in IADLs and performance-based cognitive tests are associated with current driving status, as expected. CONCLUSION These findings have clinical implications for the importance of evaluating driving concurrently with other instrumental functional abilities in MCI and dementia. Additional work is needed to determine whether proxy report of cognitive and functional impairments should help guide referrals for driving assessment and rehabilitation or counseling for driving transition.

Driving Cessation and Cognitive Dysfunction in Patients with Mild Cognitive Impairment

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Assessment of Driving Safety in Older Adults with Mild Cognitive Impairment

“…Around 60% of women with mild cognitive impairment (MCI) are current drivers, in contrast to 40% of women with dementia [2]. There is a paucity of data on the road safety of individuals with MCI, as noted in a recent systematic review that only identified one relevant study [3].…”

Drivers with Amnestic Mild Cognitive Impairment Can Benefit from a Multiple‐Session Driving Simulator Automated Training Program

“…Most of these individuals will progress to Alzheimer's disease. A large proportion of older individuals with aMCI are active drivers . It is often mentioned that most of these individuals can drive safely but that their driving is characterized by subtle functional decrements .…”