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Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1992 Apr;85(4):199–202. doi: 10.1177/014107689208500406

Dementia and driving.

D O'Neill 1, K Neubauer 1, M Boyle 1, J Gerrard 1, D Surmon 1, G K Wilcock 1
PMCID: PMC1294722  PMID: 1433058

Abstract

Many European countries test cars, but not their drivers, as they age. There is evidence to suggest that human factors are more important than vehicular factors as causes of motor crashes. The elderly also are involved in more accidents per distance travelled than middle-aged drivers. As the UK relies on self-certification of health by drivers over the age of 70 years, we examined the driving practices of patients with dementia attending a Memory Clinic. Nearly one-fifth of 329 patients with documented dementia continued to drive after the onset of dementia, and impaired driving ability was noted in two-thirds of these. Their families experienced great difficulty in persuading patients to stop driving, and had to invoke outside help in many cases. Neuropsychological tests did not help to identify those who drove badly while activity of daily living scores were related to driving ability. These findings suggest that many patients with dementia drive in an unsafe fashion after the onset of the illness. The present system of self-certification of health by the elderly for driver-licensing purposes needs to be reassessed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cartwright A. Medicine taking by people aged 65 or more. Br Med Bull. 1990 Jan;46(1):63–76. doi: 10.1093/oxfordjournals.bmb.a072395. [DOI] [PubMed] [Google Scholar]
  2. Drachman D. A. Who may drive? Who may not? Who shall decide? Ann Neurol. 1988 Dec;24(6):787–788. doi: 10.1002/ana.410240614. [DOI] [PubMed] [Google Scholar]
  3. Driving and Alzheimer's disease. Ann Neurol. 1989 Aug;26(2):289–290. doi: 10.1002/ana.410260220. [DOI] [PubMed] [Google Scholar]
  4. Eadington D. W., Frier B. M. Type 1 diabetes and driving experience: an eight-year cohort study. Diabet Med. 1989 Mar;6(2):137–141. doi: 10.1111/j.1464-5491.1989.tb02101.x. [DOI] [PubMed] [Google Scholar]
  5. Evans L. Older driver involvement in fatal and severe traffic crashes. J Gerontol. 1988 Nov;43(6):S186–S193. doi: 10.1093/geronj/43.6.s186. [DOI] [PubMed] [Google Scholar]
  6. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  7. Friedland R. P., Koss E., Kumar A., Gaine S., Metzler D., Haxby J. V., Moore A. Motor vehicle crashes in dementia of the Alzheimer type. Ann Neurol. 1988 Dec;24(6):782–786. doi: 10.1002/ana.410240613. [DOI] [PubMed] [Google Scholar]
  8. Hansotia P., Broste S. K. The effect of epilepsy or diabetes mellitus on the risk of automobile accidents. N Engl J Med. 1991 Jan 3;324(1):22–26. doi: 10.1056/NEJM199101033240105. [DOI] [PubMed] [Google Scholar]
  9. Henderson A. S., Huppert F. A. The problem of mild dementia. Psychol Med. 1984 Feb;14(1):5–11. doi: 10.1017/s0033291700003020. [DOI] [PubMed] [Google Scholar]
  10. Huff F. J., Becker J. T., Belle S. H., Nebes R. D., Holland A. L., Boller F. Cognitive deficits and clinical diagnosis of Alzheimer's disease. Neurology. 1987 Jul;37(7):1119–1124. doi: 10.1212/wnl.37.7.1119. [DOI] [PubMed] [Google Scholar]
  11. Lucas-Blaustein M. J., Filipp L., Dungan C., Tune L. Driving in patients with dementia. J Am Geriatr Soc. 1988 Dec;36(12):1087–1091. doi: 10.1111/j.1532-5415.1988.tb04394.x. [DOI] [PubMed] [Google Scholar]
  12. Mayeux R., Stern Y., Spanton S. Heterogeneity in dementia of the Alzheimer type: evidence of subgroups. Neurology. 1985 Apr;35(4):453–461. doi: 10.1212/wnl.35.4.453. [DOI] [PubMed] [Google Scholar]
  13. O'Connor D. W., Pollitt P. A., Hyde J. B., Brook C. P., Reiss B. B., Roth M. Do general practitioners miss dementia in elderly patients? BMJ. 1988 Oct 29;297(6656):1107–1110. doi: 10.1136/bmj.297.6656.1107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Pfeffer R. I., Afifi A. A., Chance J. M. Prevalence of Alzheimer's disease in a retirement community. Am J Epidemiol. 1987 Mar;125(3):420–436. doi: 10.1093/oxfordjournals.aje.a114548. [DOI] [PubMed] [Google Scholar]
  15. Reuben D. B., Silliman R. A., Traines M. The aging driver. Medicine, policy, and ethics. J Am Geriatr Soc. 1988 Dec;36(12):1135–1142. doi: 10.1111/j.1532-5415.1988.tb04403.x. [DOI] [PubMed] [Google Scholar]
  16. Rocca W. A., Fratiglioni L., Bracco L., Pedone D., Groppi C., Schoenberg B. S. The use of surrogate respondents to obtain questionnaire data in case-control studies of neurologic diseases. J Chronic Dis. 1986;39(11):907–912. doi: 10.1016/0021-9681(86)90039-1. [DOI] [PubMed] [Google Scholar]
  17. Schlotterer G., Moscovitch M., Crapper-McLachlan D. Visual processing deficits as assessed by spatial frequency contrast sensitivity and backward masking in normal ageing and Alzheimer's disease. Brain. 1984 Mar;107(Pt 1):309–325. doi: 10.1093/brain/107.1.309. [DOI] [PubMed] [Google Scholar]
  18. Steffes R., Thralow J. Visual field limitation in the patient with dementia of the Alzheimer's type. J Am Geriatr Soc. 1987 Mar;35(3):198–204. doi: 10.1111/j.1532-5415.1987.tb02309.x. [DOI] [PubMed] [Google Scholar]
  19. Stevens A. B., Roberts M., McKane R., Atkinson A. B., Bell P. M., Hayes J. R. Motor vehicle driving among diabetics taking insulin and non-diabetics. BMJ. 1989 Sep 2;299(6699):591–595. doi: 10.1136/bmj.299.6699.591. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Waller J. A. Health status and motor vehicle crashes. N Engl J Med. 1991 Jan 3;324(1):54–55. doi: 10.1056/NEJM199101033240110. [DOI] [PubMed] [Google Scholar]
  21. Watson J. S., Matsuyama S. S., Dirham P. M., Liston E. H., La Rue A., Jarvik L. F. Relatives' descriptions of changes in symptoms of dementia of the Alzheimer type: a comparison of retrospective and concurrent ratings. Alzheimer Dis Assoc Disord. 1987;1(2):98–102. doi: 10.1097/00002093-198701020-00005. [DOI] [PubMed] [Google Scholar]

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