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Seiler, S; Schmidt, H; Lechner, A; Benke, T; Sanin, G; Ransmayr, G; Lehner, R; Dal-Bianco, P; Santer, P; Linortner, P; Eggers, C; Haider, B; Uranues, M; Marksteiner, J; Leblhuber, F; Kapeller, P; Bancher, C; Schmidt, R; PRODEM Study Group.
Driving cessation and dementia: results of the prospective registry on dementia in Austria (PRODEM).
PLoS One. 2012; 7(12):e52710-e52710 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG

 

Autor/innen der Med Uni Graz:
Kapeller Peter
Lechner Anita
Linortner Patricia
Schmidt Helena
Schmidt Reinhold
Seiler Stephan
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Abstract:
Objective: To assess the influence of cognitive, functional and behavioral factors, co-morbidities as well as caregiver characteristics on driving cessation in dementia patients. Methods: The study cohort consists of those 240 dementia cases of the ongoing prospective registry on dementia in Austria (PRODEM) who were former or current car-drivers (mean age 74.2 (+/- 8.8) years, 39.6% females, 80.8% AlzheimerANDapos;s disease). Reasons for driving cessation were assessed with the patientsANDapos; caregivers. Standardized questionnaires were used to evaluate patient-and caregiver characteristics. Cognitive functioning was determined by Mini-Mental State Examination (MMSE), the CERAD neuropsychological test battery and Clinical Dementia Rating (CDR), activities of daily living (ADL) by the Disability Assessment for Dementia, behavior by the Neuropsychiatric Inventory (NPI) and caregiver burden by the Zarit burden scale. Results: Among subjects who had ceased driving, 136 (93.8%) did so because of ANDquot;Unacceptable riskANDapos;ANDapos; according to caregiverANDapos;s judgment. Car accidents and revocation of the driving license were responsible in 8 (5.5%) and 1(0.7%) participant, respectively. Female gender (OR 5.057; 95% CI 1.803-14.180; p = 0.002), constructional abilities (OR 0.611; 95% CI 0.445-0.839; p = 0.002) and impairment in Activities of Daily Living (OR 0.941; 95% CI 0.911-0.973; pANDlt;0.001) were the only significant and independent associates of driving cessation. In multivariate analysis none of the currently proposed screening tools for assessment of fitness to drive in elderly subjects including the MMSE and CDR were significantly associated with driving cessation. Conclusion: The risk-estimate of caregivers, but not car accidents or revocation of the driving license determines if dementia patients cease driving. Female gender and increasing impairment in constructional abilities and ADL raise the probability for driving cessation. If any of these factors also relates to undesired traffic situations needs to be determined before recommendations for their inclusion into practice parameters for the assessment of driving abilities in the elderly can be derived from our data.
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Adult -
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Alzheimer Disease - epidemiology
Alzheimer Disease - epidemiology
Automobile Driving - statistics & numerical data
Caregivers -
Cognition -
Female -
Geriatric Assessment -
Health Care Costs -
Humans -
Licensure -
Logistic Models -
Male -
Middle Aged -
Multivariate Analysis -
Neuropsychological Tests -
Prospective Studies -
Psychiatric Status Rating Scales -
Questionnaires -
Registries -
Risk -
Risk Factors -
Severity of Illness Index -

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