Year: 2013
Type: article
Abstract: The prevalence of older adults is increasing along with those drivers with underlying mild cognitive impairment and/or dementing illnesses. Older adults are at increased risk for a motor vehicle crash per miles driven, increased vulnerability for injury in a crash compared to other age groups, and at increased risk for driving retirement. Family members and patients rely on clinician advice for driving competency and/or decisions related to driving cessation. The evidenced-based literature will be reviewed in the following areas; crash risk in older adults with dementia, impairments on performance-based road tests, predictive tools for determining fitness-to-drive, consensus statements on basing recommendations on the level of dementia severity, and educational programs that are available to improve confidence attitudes, knowledge, and practice behavior in addressing driving competency and retirement. Most, but not all studies, reveal an elevated crash risk in older adults with dementia in comparison to age-matched controls. Impairments in driving behaviors during performance-based road tests are commonly observed in demented drivers, but the differences between dements and controls may be more quantitative than qualitative. Brief functional screens are available that may assist clinicians in determining who may be at-risk and be appropriate for referral for performance-based road testing. However, there are no brief screens that should be the sole determinant of driving privileges. Driving Rehabilitation Specialists based at driving clinics may be helpful to the clinician in determining fitness-to-drive. Educational curriculums are available to the clinician that may improve knowledge and competency in this area along with potential changes in practice behavior. Clinicians will be evaluating more demented drivers in the next few decades. A comprehensive approach is warranted to determine fitness-to-drive and assist with transportation alternatives when driving cessation is appropriate. Social workers, gerontological care managers, and occupational therapists may be helpful in assisting families and clinicians with these difficult issues. This session will conclude with a discussion of the ethical and legal issues that make assessment and intervention of the demented driver challenging, but should assist the clinician in avoiding common pitfalls.
Source: Alzheimer s & Dementia
Author: David Carr
Institution: Washington University in St. Louis
Language: English
Topic: Older Adults Driving Studies
Field: Health Professions
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2035838885