The Medical Referral Process and Motor-Vehicle Crash Risk for Drivers with Dementia

Davis, Jonathan; Hamann, Cara; Butcher, Brandon; Peek‐Asa, Corinne

doi:10.3390/geriatrics5040091

Cited by 3 publications

(8 citation statements)

References 21 publications

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“…Noticing that other drivers honk frequently 14. Having trouble making left turns articles were selected for full reading; six were observational studies [12][13][14][15][16][17] and only one with an intervention method. 18 The remaining 16 selected studies were distributed among literature reviews, editorials or letters.…”

Section: Resultsmentioning

confidence: 99%

“…18 The remaining 16 selected studies were distributed among literature reviews, editorials or letters. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] All studies were carried out in high-income countries such as the United Kingdom, [13][14][15]19,22,28,30,32 the USA 9,12,[16][17][18]21,25,26,31,33 and Australia. 27,29 The reduced number of studies that include intervention or observation methodology may indicate a methodological difficulty in evaluating older drivers, especially those with AD; however, the scientific gap on the subject justifies the need for greater commitment in the search for better knowledge about older driver safety and older drivers with AD.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis of Alzheimer's dementia and vehicle driving restriction: a scoping review

de Almeida,

Quintas,

Trindade

et al. 2023

Psychogeriatrics

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There are doubts about vehicle driving restriction for patients with Alzheimer's disease. A scoping review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis Protocols (PRISMA‐ScR) methodology. Relevant databases were searched for articles published between 2000 and 2022 in English, Spanish, or Portuguese. Articles were included if they specifically addressed driving, risk of accidents, permission or licence to drive a motor vehicle in a context of important cognitive decline, or if addressed traffic legislation on driving and dementia. Twenty‐three articles were selected for full reading, six of which were observational studies and only one with an interventionist method. All articles were carried out in high‐income countries such as the UK, the US, and Australia. As a conclusion, there is no psychometric test in the literature sensitive enough to assess vehicle driving competence in older adults with cognitive deficits. Based on selected studies, there is no robust evidence to make recommendation for or against the cessation of vehicular driving for patients with mild cognitive decline or with mild dementia. In some situations, vehicle driving cessation can impact patients and their families. In addition, legal regulations regarding vehicle driving for older adults and people with dementia are scarce worldwide. Despite the scarcity of studies addressing the theme of vehicle driving in the context of dementia, there is some level of consensual reasoning that patients with moderate to severe dementia should halt driving activities, but the same does not apply for patients with mild levels of cognitive impairment, including mild dementia.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Diagnosis of Alzheimer's dementia and vehicle driving restriction: a scoping review

de Almeida,

Quintas,

Trindade

et al. 2023

Psychogeriatrics

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“…While these adaptations increased the ease of licensure in addition to increasing COVID-19 safety, they may have a negative influence on road safety. Issues that could interfere with a person’s ability to drive, such as cognitive impairment or decline, are often caught during in-person licensure renewal procedures, particularly among the senior population [24] , [25] . Therefore, policies that delay visits to the DMV, may impact road safety by allowing individuals with these issues to continue driving without necessary precautions.…”

Section: Discussionmentioning

confidence: 99%

Balancing safety on the road with risk from COVID-19: A content analysis of policy adaptations by Divisions of Motor Vehicles

Feiss

Hautmann

Asa

et al. 2021

Accident Analysis & Prevention

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Purpose The COVID-19 pandemic significantly altered people’s daily lives, including driving. However, how state Divisions of Motor Vehicles (DMV) adapted their operation policies in response to COVID-19 remains unknown. This study analyzed adaptations to the content of state DMV operation policies during the COVID-19 pandemic across 50 US states and assessed the relationships between these policy adoptions and their state-level COVID-19 restriction orders. Methods We merged data on policy adaptations due to COVID-19 obtained from DMV websites for all 50 states with data on state-level restrictions obtained from the National Academy for State Health Policy (NASHP). We created a codebook and analyzed the DMV policy adaptations in the following three areas: (1) road testing, (2) licensure extension and renewals, and (3) facility reopening. Two trained coders independently reviewed and coded the adaptations of policy content related to precaution to spread of COVID-19 and ease of obtaining licensure. We calculated summary scores for policy adaptations and ease of licensure and compared these scores across three categories of state-level COVID-19 restrictions using ANOVA. Results DMVs in all 50 states adapted their policies to slow the spread of COVID-19. The ease of licensure summary scores increased in some states but decreased in others. Extensions for licensure renewals was the most common change. Adoption of COVID-19 precautions during the road test was the most common road test adaptation, while road test waivers were the most controversial. Requiring appointments, social distancing, and/or face coverings/personal protective equipment [PPE] were common adaptations during facility reopening. However, variations in level of policy adaptations and ease of licensure were not associated with the state’s COVID-19 restrictions. Conclusions Our findings provide insight into policy adaptations made by state DMVs to reduce the spread of COVID-19 and may inform future policy adaptations in DMVs and other government agencies during public health emergencies.

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“…Most naturalistic and standardized on-road tests suggest that AD patients perform more driving safety errors and their driving ability is inferior to that of healthy elderly individuals ( Zuin et al, 2002 ; Uc et al, 2004 ; Lincoln et al, 2006 ; Dawson et al, 2009 ; Aksan et al, 2015 ; Barco et al, 2015 ). Recently, Davis et al (2020) showed that drivers with dementia undergoing a license review were far more likely to have their license denied than those without dementia (69.2% vs. 10.3%). Fuermaier et al (2019) found that individuals with AD, who failed the on-road test, had worse results on operational, tactical and visual aspects of driving compared to individuals with AD who passed the on-road test.…”

Section: Driving Ability and Oculo-visual Disorders In Dementiamentioning

confidence: 99%

“…Interestingly, some patients of the AD group who experienced a crash, were looking directly at the road but did not avoid the crash. A possible explanation was the “looking without seeing” attitude, which has been described in patients with dorsolateral lesions of the visual cortex due to stroke or AD ( Rizzo and Hurtig, 1987 ; Hof et al, 1990 ; Mendez et al, 1990 ; Rizzo, 1993 ; Davis et al, 2020 ).…”

Section: Driving Ability and Oculo-visual Disorders In Dementiamentioning

confidence: 99%

Visual disorders and driving ability in persons with dementia: A mini review

Papageorgiou

Tsirelis

Lazari

et al. 2022

Front. Hum. Neurosci.

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BackgroundImpaired driving ability in patients with Alzheimer’s disease (AD) is associated with a decline in cognitive processes and a deterioration of their basic sensory visual functions. Although a variety of ocular abnormalities have been described in patients with AD, little is known about the impact of those visual disorders on their driving performance.AimAim of this mini-review is to provide an update on the driving ability of patients with dementia and summarize the primary visual disorders affecting their driving behavior.MethodsDatabases were screened for studies investigating dementia, associated visual abnormalities and driving ability.ResultsThere is consistent evidence that dementia affects driving ability. Patients with dementia present with a variety of visual disorders, such as visual acuity reduction, visual field defects, impaired contrast sensitivity, decline in color vision and age-related pathological changes, that may have a negative impact on their driving ability. However, there is a paucity in studies describing the impact of oculovisual decline on the driving ability of AD subjects. A bidirectional association between cognitive and visual impairment (VI) has been described.ConclusionGiven the bidirectional association between VI and dementia, vision screening and cognitive assessment of the older driver should aim to identify at-risk individuals and employ timely strategies for treatment of both cognitive and ocular problems. Future studies should characterize the basic visual sensory status of AD patients participating in driving studies, and investigate the impact of vision abnormalities on their driving performance.

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The Medical Referral Process and Motor-Vehicle Crash Risk for Drivers with Dementia

Cited by 3 publications

References 21 publications

Diagnosis of Alzheimer's dementia and vehicle driving restriction: a scoping review

Diagnosis of Alzheimer's dementia and vehicle driving restriction: a scoping review

Balancing safety on the road with risk from COVID-19: A content analysis of policy adaptations by Divisions of Motor Vehicles

Visual disorders and driving ability in persons with dementia: A mini review

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