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Longitudinal Study of Driving Habits and Cessation in Older Persons with Dementia

Geri Adler
University of Minnesota
4349 Browndale Avenue South
St. Louis Park MN 55424
612/725-2051
FAX: 612/725-2084
adle0009@tc.umn.edu

Purpose: Much of the driving and dementia literature focuses on determining driving competency, ignoring the psychosocial factors that influence driving behaviors and the consequences of driving cessation. This study examined the ongoing driving habits and driving cessation process of older persons with dementia.

Methods: At baseline, 43 male drivers with dementia completed a questionnaire obtaining information about driving history, current 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, availability and use of transportation alternatives, and adjustment to driving cessation. The Mini-Mental State Examination (MMSE) was administered to all subjects at baseline and to drivers at follow-up. For non-drivers, a MMSE scored near the time of discontinuation was obtained.

Results: Twenty-three subjects (54%) were no longer driving at follow-up. The decision to stop was abrupt and usually made in response to physician or family recommendations. Drivers continued to drive often (mean, 4.7 days/week) and few (20%) made plans to stop, although 25% reported family concern about their driving competence. Using Cox’s proportional-hazards regression model, MMSE (p=0.001) and age (p=0.03) were shown to be significant predictors of elapsed time to driving cessation.

Implications for policy and practice: Findings indicate that a surprising number of men with dementia continue to drive for several years after disease onset. In the interest of public safety, policy-makers must develop uniform guidelines to assess and regulate drivers with dementia. Social workers must work with drivers and their families to develop a plan for driving cessation, which includes information about transportation alternatives and addresses the impact cessation has on independence and self-esteem.