summary: A recent survey found that the majority of seniors with cognitive impairment in southern Texas still drive, raising safety concerns.
Of more than 600 individuals evaluated, 61.4% of those with cognitive impairment were positive drivers. A person with a mild disability may be able to drive safely, but for others it may be inappropriate driving.
This study highlights the importance of early and open discussion among patients, caregivers, and health care providers about safe driving practices.
Important facts:
- 61.4% of the cognitively impaired older adults surveyed in this study continue to drive.
- Regardless of ethnicity, the degree of cognitive impairment reduces the likelihood of driving.
- About 35% of caregivers expressed concern about their care recipient’s ability to drive safely.
sauce: University of Michigan
A Michigan Medicine survey of communities in South Texas found that the majority of older adults with cognitive impairment still drive despite concerns from caregivers and others.
Researchers evaluated more than 600 adults aged 65 and older in Nueces County, Texas, who had cognitive assessment scores indicative of possible disability.
Among those with cognitive impairment, 61.4% were current drivers, and approximately one-third of all caregivers were concerned about their care recipient’s driving.
Result is, Journal of the American Geriatrics Society.
“It’s probably appropriate for people with mild cognitive impairment to still drive, but it may not be for some people,” said lead author Louis B. Morgenstern, M.D., Ph.D., professor of neurology, neurosurgery, and emergency medicine at the University of Michigan School of Medicine and professor of epidemiology at the UM School of Public Health.
“Patients and caregivers should discuss these issues with their healthcare providers and consider roadway driving assessments to ensure safety.”
It is estimated that about 1 in 9 Americans over the age of 65, or 6.7 million people, have Alzheimer’s disease, and millions more have associated dementia.
These conditions can affect neuropsychological and visual skills and reduce your ability to drive safely. A 2017 review of the risk of motor vehicle crashes found that dementia has a moderate to significant impact on driving impairment, with people with dementia being more likely than those without to fail a road test.
Investigators initially set out to examine the prevalence of motor vehicle driving among white Latino older adults and non-Latino white adults, but found no significant difference between the two groups. But the more cognitively impaired you are, the less likely you are to drive.
Over 35% of caregivers were concerned about their care recipient’s ability to drive safely, even though many of the study participants limited the amount of driving and avoided driving at night or in the rain.
Discussions about driving between caregivers and people with cognitive impairment are difficult due to concerns about loss of autonomy and possible embarrassment. Caregiver burden can also increase when people with cognitive impairment stop driving.
Researchers say it’s best to start conversations about driving early, while the care recipient can understand and actively participate in the discussion.
“Relatives may discuss pre-driving directives with older loved ones,” Morgenstern said.
“These are agreements between seniors and loved ones to discuss driving suspensions.”
Other authors include Madelyn Malvitz, Darin B. Zahuranec, MD, Wen Chang, Steven G. Heeringa, Ph.D., Emily M. Briceño, Ph.D., Roshanak Mehdipanah, Ph.D., Deborah A. Levine, MD, Kenneth M. Langa, MD, Ph.D., Nelson Garcia, all at the University of Michigan, and Xavier F. Gonzales, Ph.D. Included. D. of Texas A&M, Corpus Christi.
Funding: This work was supported by the National Institute of Neurological Disorders and Stroke and the National Institute on Aging at the National Institutes of Health (grant grants R01NS100687, R01AG069148, and P30AG024824).
The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Kenneth M. Langa has received grants from the NIA and the Alzheimer’s Association and is consulting on NIH-funded projects related to identifying dementia in population-based studies. Lewis B. Morgenstern, Emily M. Briceño, Roshanak Mehdipanah, Deborah A. Levine, Darin B. Zahuranec, and Steven G. Heeringa He received a grant from the NIH.
About this research news on aging and cognitive decline
author: Noah Fromson
sauce: University of Michigan
contact: Noah Fromson – University of Michigan
image: Image credited to Neuroscience News
Original research: open access.
“Driving predictors in a cohort of Mexican Americans and non-Hispanic whites with cognitive impairmentby Louis B. Morgenstern et al. Journal of the American Geriatrics Society
overview
Driving predictors in a cohort of Mexican Americans and non-Hispanic whites with cognitive impairment
Background
People with Alzheimer’s disease and Alzheimer’s disease-related dementia may lose the ability to drive safely as the disease progresses. Little is known about its increased prevalence among older Latinos and non-Hispanic whites (NHWs). We investigated the prevalence of driving situations among cognitively impaired individuals in a population-based cohort.
method
This was a cross-sectional analysis of a cohort BASIC cognitive study in the Mexican-American (MA) and NHW communities of South Texas. The participant had a score of 25 or less on the Montreal Cognitive Assessment (MoCA), indicating possible cognitive impairment. Current driving status was assessed by informant interview of the Concordant Cognitive Assessment Protocol. Logistic regression was used to adjust for pre-specified covariates to assess driving versus non-driving.Chi-Square and Mann Whitney U A test was used to compare differences between NHW and MA in driving outcomes, based on the American Academy of Neurology (AAN) question for assessing driving risk for dementia.
result
There were 635 participants, average age 77.0, female 62.4%, average MoCA 17.3. Of these, 360 (61.4%) were active drivers, 250 out of 411 MA participants (60.8%) were driving, and 121 out of 190 NHW participants (63.70%) were driving (p= 0.50). In the fully adjusted model, age, gender, cognitive impairment, language preference, and daily living activity score were significant predictors of driving likelihood (p< 0.0001). Severity of cognitive impairment was inversely associated with likelihood of driving, but this relationship was not found among those who preferred Spanish in interviews. About one-third of all caregivers were concerned about their care recipient's driving. There were no significant differences in MA and NHW driving habits and AAN questionnaire results.
Conclusion
The majority of participants with cognitive impairment are currently driving. This is a cause for concern for many caregivers. There was no significant difference between driving races. Further research is needed on the association with current driving in cognitively impaired individuals.