Longitudinal study of driving habits and cessation in older persons with dementia.

摘要

Demographic trends indicate that the number of licensed drivers 60 years and older will increase dramatically over the coming years. Because Alzheimer's disease and other dementing illnesses are age-associated, the number of elders with these diseases will also rise. Memory loss, impaired judgment, and visual-spatial disturbances are hallmark features of dementia as well as abilities vital to safe driving. Decisions to alter driving patterns and ultimately to stop driving altogether are particularly problematic for drivers with dementia who maintain physical function but lack insight. The purpose of this dissertation is to examine the ongoing driving habits and driving cessation process of older persons with dementia.; This study combines two data sets to create a longitudinal study of 43 older persons with dementia. At baseline, drivers with dementia completed a questionnaire obtaining information about driving history, driving habits, driving pattern changes, and expectations about driving cessation. Three years later, subjects were queried again. For continuing drivers, information was collected about their current driving habits and plans for cessation. Subjects who discontinued driving were asked about the decision-making process and adjustment to driving cessation. A Mini-Mental State Examination (MMSE) score was obtained for subjects at data collection.; Data analyses reveals that a surprising number of individuals with dementia continue to drive well after symptom onset. Using a logistic regression model, lower MMSE scores and increased age were found to be the only significant predictors of driving status. For those elders who stopped driving, the decision was abrupt, unplanned, and usually made on physician and family recommendation.; These results have implications both for social work practice and public policy. Social workers must be mindful of the potential risks associated with driving and dementia, aware of the social, psychological, and practical implications of driving cessation, and cognizant of transportation resources. In the interest of public safety, citizens must be educated, licensing practices be evaluated, professionals' legal responsibilities clarified, and more attention devoted to the transportation needs of those who can no longer drive.