Alzheimer's Disease and Driving: Prediction and Assessment of Driving Performance

Fox, Gillian K.; Bowden, Stephen C.; Bashford, Guy; Smith, Dennis S.

doi:10.1111/j.1532-5415.1997.tb02965.x

Cited by 155 publications

(113 citation statements)

References 18 publications

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“…At the time of the study, 30% of the sample subjects continued to drive for 3.6 years following diagnosis. Fox and others reported that their study subjects were driving an average of 4 years (SD 2.0) following diagnosis (16). In a study by Bedard and colleagues, the mean interval between the onset of symptoms and a clinical assessment that included information about patients' driving history was 5.5 years (95%CI, 5.2 to 5.8 years) (17).…”

Section: )mentioning

confidence: 99%

Driving and Dementia in Ontario: A Quantitative Assessment of the Problem

et al. 2004

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P rogressive dementia (most often Alzheimer's disease) is a major concern in an aging population. The most common deficits seen in dementia are impairments in memory, concentration (vigilance), judgement, and eventually, motor function. The impact of these and other cooccurring losses on everyday activities is devastating. One activity of particular importance is driving. In our society, driving has a special status among activities as it is considered a necessity, a right, and a symbol of independence (1-3). However, this "right" must be balanced by the need for public safety. While driving is a common activity across all age groups and is not without risk, there are age-related changes owing to dementia that create specific risks. Other studies have examined the deficits among drivers with dementia. This paper determines a quantitative estimate of the size of the problem that we are currently experiencing and are likely to experience in the next 25 years in 434

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Section: )mentioning

confidence: 99%

Driving and Dementia in Ontario: A Quantitative Assessment of the Problem

et al. 2004

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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%

“…49 In some small studies, the MMSE has not been found to be a reliable method of predicting driving performance. 44,50 Since this tool was not originally designed to assess cognitive function with respect to driving, the MMSE as a measure to assess driving performance lacks validity when used to assess patients falling between the extremes of cognitive impairment. 7,51 The Useful Field of View (UFOV) is a computer-administered test that measures and detects abnormalities in the speed of visual processing and sensory function.…”

Section: Methods Of Assessmentmentioning

confidence: 99%

“…44,45 In the early stages of mild cognitive impairment, neuropsychiatric testing may be useful in determining those specific deficits that may affect the ability to drive safely, particularly the more subtle aspects of cognitive function. These tests are poor predictors of future risk for crashes or violations.…”

Section: Methods Of Assessmentmentioning

confidence: 99%

“…Despite the diagnosis, most patients with Alzheimer's disease continue to drive for as long as 4 years. 44,51 Given the heterogeneity among patients with widely ranging cognitive dysfunction, it is important to assess patients systematically and to individualize recommendations. 56…”

Section: License Revocationmentioning

confidence: 99%

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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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Measurement of progression in Alzheimer's disease: a clinician's perspective

Gelb

2000

Statist. Med.

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Patients with Alzheimer's disease (AD) and their families must confront two fundamental truths. First, AD is a uniformly progressive disease that ultimately results in debilitating cognitive impairment. Second, although there is now evidence that some medications may produce transient improvement or possibly even slowing of disease progression, there is currently no way to halt the progression of AD. Consequently, patients and their families consistently ask the following questions: 1. What new management issues can be anticipated, and when? 2. What clinical developments are atypical and merit evaluation for a superimposed problem? 3. Is the current treatment working? These questions can only be answered by referring to the natural course of AD, and speciÿcally, information regarding measures of functional impairment and how they change over time. The information that is currently available on this topic is limited and often embodies implicit assumptions that have not been adequately tested. This information will be reviewed, and directions for future research will be outlined.

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Alzheimer's Disease and Driving: Prediction and Assessment of Driving Performance

Cited by 155 publications

References 18 publications

Driving and Dementia in Ontario: A Quantitative Assessment of the Problem

Driving and Dementia in Ontario: A Quantitative Assessment of the Problem

Neurologic Conditions: Assessing Medical Fitness to Drive

Measurement of progression in Alzheimer's disease: a clinician's perspective

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