Mild Cognitive Impairment and Everyday Function: An Investigation of Driving Performance

Abstract

Mild Cognitive Impairment (MCI) involves subtle functional losses that may include decrements in driving skills. We compared 46 participants with MCI to 59 cognitively normal controls on a driving evaluation conducted by a driving rehabilitation specialist who was blinded to participants' MCI classification. Participants with MCI demonstrated significantly lower performance than controls on ratings of global and discrete driving maneuvers, but these differences were not at the level of frank impairments. Rather, performance was simply less than optimal, which to a lesser degree was also characteristic of a subset of the cognitively normal control group. The finding of significantly lower global driving ratings, coupled with the increased incidence of dementia among people with MCI and the known impact of dementia on driving safety, suggests the need for increased vigilance among clinicians, family members, and individuals with MCI for initially benign changes in driving that may become increasingly problematic over time.

Effects of Driving Skill Training on Safe Driving in Older Adults with Mild Cognitive Impairment

“…Although there is evidence of driving rehabilitation in disabled adults [20, 22], the effects of interventions on safe driving were not clear in older adults with cognitive impairment [20, 21] who had low driving skills [23, 24]. More evidence from research is needed on older adults with cognitive impairment to propose recommendations regarding interventions for improving driving skills.…”

Mild Cognitive Impairment and Driving Cessation: A 3-Year Longitudinal Study

“…It is relatively common - occurring in around 20% of people over the age of 65 years [2] - and is considered to be an intermediate stage between normal ageing and dementia, though not all people with MCI develop dementia [3,4]. One practical consequence of the condition is that it can affect a person's ability to drive [5,6,7]. For some, this may necessitate that they stop driving, either immediately or in the longer term.…”

Longitudinal Research on Aging Drivers (Longroad): Study Design and Methods

“…Calculations were based on cognitive impairment as the exposure variable of primary interest, as cognitive impairment is consistently reported to be a strong predictor of crash involvement and driving cessation in older adults (Edwards et al 2010). The incidence of mild cognitive impairment in older adults is about 5 per 100 person-years (Wouters et al 2010), the incidence of crashes in older adult drivers is about 5 per 100 person-years (Staplin et al 2003), and the risk ratio of crash involvement associated with mild cognitive impairment is reported to be 4.2 (Wadley et al 2009). At an α level 0.05 and a β level of 0.80, the required sample size is estimated to be approximately 360 person-years for each single-year age stratum between 65 years and 79 years, or 5400 person-years in total for detecting a risk ratio of 3.0.…”