dementia & driving
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Introduction
Also see dementia, driving & California state law
Clinical significance
- cognitively impaired older drivers are a risk to other drivers, pedestrians, their passengers & themselves[4]
- GPS* monitoring reportedly identifies 5 driving features that predict preclinical Alzheimer's disease as determined by CSF Abeta40/Abeta42[6]
* GPS: global positioning system
Management
- no clinical test accurately quantifies risk
- a rating scale that assesses orientation, judgement, participation in community affairs, self-directed participation in home activities, & personal care is allegedly helpful in assessing diving risk[3]
- a clinical dementia rating (CDR) should prompt a discussion of driving cessation[1]
- in some states, including California, dementia may be reportable to the Health Departement (see dementia, driving & California state law)
- mandatory physician reporting does not affect incidence of dementia-associated crash hospitalizations[5]
More general terms
Additional terms
References
- ↑ 1.0 1.1 Journal Watch Aging/Geriatrics Alert for November 1, 2010 Massachusetts Medical Society http://www.jwatch.org
Iverson DJ et al. Practice parameter update: Evaluation and management of driving risk in dementia. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2010 Apr 20; 74:1316. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20385882 - ↑ Medical Knowledge Self Assessment Program (MKSAP) 16, 18. American College of Physicians, Philadelphia 2012, 2018.
- ↑ 3.0 3.1 Carr DB, Ott BR. The older adult driver with cognitive impairment: "It's a very frustrating life". JAMA. 2010 Apr 28;303(16):1632-41. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20424254
- ↑ 4.0 4.1 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
- ↑ 5.0 5.1 Agimi Y, Albert SM, Youk AO, Documet PI, Steiner CA. Dementia and motor vehicle crash hospitalizations: Role of physician reporting laws. Neurology. February 27, 2018; 90 (9). Online 2018 Jan 31; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29386271 <Internet> http://n.neurology.org/content/90/9/e808
- ↑ 6.0 6.1 George J Driving Patterns Pinpoint Early Alzheimer's Disease. Subtle shifts in on-road behavior suggest GPS-based biomarkers may have merit. MedPage Today July 30, 2021 https://www.medpagetoday.com/meetingcoverage/aaic/93840
- ↑ AMA Physician's Guide to Assessing and Counseling Older Drivers http://www.ama-assn.org/ama/pub/physician-resources/public-health/promoting-healthy-lifestyles/geriatric-health/older-driver-safety/assessing-counseling-older-drivers.shtml
- ↑ Elia J, Sofair A, Chavey WE Guidelines Issued on Dementia and Driving Physician's First Watch, Dec 14, 2018 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
DRIVING WITH DEMENTIA OR MILD COGNITIVE IMPAIRMENT Consensus Guidelines for Clinicians https://research.ncl.ac.uk/driving-and-dementia/consensusguidelinesforclinicians/Final%20Guideline.pdf
Report a medically impaired driver (in Massachussetts) https://www.mass.gov/how-to/report-a-medically-impaired-driver - ↑ National Institute on Aging. Driving Safety and Alzheimer's Disease. https://www.nia.nih.gov/health/driving-safety-and-alzheimers-disease