Caregiver Prediction of Driving Fitness in Older Adults with Dementia

ABSTRACT

Objectives: To determine whether caregiver opinion of fitness to drive and the level of assistance needed for functional activities are useful in determining the need for a Comprehensive Driving Evaluation.

Methods: This study examined a sample (N = 179) of drivers with dementia. Caregivers completed a questionnaire that included caregiver opinion of driving fitness and the Functional Assessment Questionnaire (FAQ). A univariate simple logistic regression model was used to examine the relationship of road test failure with caregiver opinion of driving fitness and FAQ scores. From the significant predictive variables from the univariate test, multiple logictic regression models were used to examine possible combination of variables as predictors of road test failure.

Results: The combination of caregiver opinion of driving fitness and the FAQ sub-item for memory were found to have modest ability in predicting failure on a standardized on-road driving assessment (AUC 0.727).

Conclusions: Caregiver opinion of driving fitness and most individual higher order activities of daily living were found to be independent predictors of failure on a standardized road test.

Clinical Implications: Caregiver opinion of driving fitness and ratings of functional activities may be useful for families and clinicians in considering whether an adult with dementia should be more carefully assessed for fitness to drive.

KEYWORDS:

• Driving
• Functional Assessment
• older drivers
• Caregiver Assessment
• dementia
• aging
• fitness to drive

Clinical implications

• As cognitive impairment progresses in adults with dementia, it is critical to recognize when their driving may pose a risk to themselves and others.

• Utilizing tools caregivers have readily available may play a critical role in early detection of the need for a CDE or driving cessation.

• Utilizing a caregiver calculator that incorporates caregiver opinion of driving quality and FAQ item score for memory may be both feasible and beneficial to families and physicians in recognizing the need for a CDE or driving cessation in adults with dementia.

Acknowledgments

We acknowledge and express appreciation to the Missouri Department of Transportation, Traffic and Highway Safety Division for funding to support this study [grant numbers 17-DL-02-001, 16-DL-02-003, 15-DL-02-003, 14-DL-02-002, 13-DL-02-001, 12-DL-02-001, 11-DL-02-2, 10-PT-02-152, 09-PT-02-162, 08-PT-02-142]. Preliminary work on this project was presented at the International Alzheimer Association International Conference in Boston, MA, July 13th–18th, 2013.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Additional information

Funding

This work was supported by the Missouri Department of Transportation, Division of Highway Safety under grant numbers 17-DL-02-001, 16-DL-02-003, 15-DL-02-003, 14-DL-02-002, 13-DL-02-001, 12-DL-02-001, 11-DL-02-2, 10-PT-02-152, 09-PT-02-162, 08-PT-02-142.