Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic
Background: Decisions around driving retirement are difficult for older persons living with cognitive decline and their caregivers. In many jurisdictions, physicians are responsible for notifying authorities of driving risks. However, there are no standardized guidelines for this assessment. Having...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Geriatrics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2308-3417/8/1/7 |
| _version_ | 1797620711116767232 |
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| author | Frank Knoefel Shehreen Hossain Amy T. Hsu |
| author_facet | Frank Knoefel Shehreen Hossain Amy T. Hsu |
| author_sort | Frank Knoefel |
| collection | DOAJ |
| description | Background: Decisions around driving retirement are difficult for older persons living with cognitive decline and their caregivers. In many jurisdictions, physicians are responsible for notifying authorities of driving risks. However, there are no standardized guidelines for this assessment. Having access to a driving risk assessment tool could help older adults and their caregivers prepare for discussions around driving retirement. This study compares the clinical profiles of older adult drivers assessed in an academic memory clinic who were referred to the driving authority to older drivers who were not with a focus on instrumental activities of daily living (iADLs). Methods: Data on referred (R) and not-referred (NR) drivers were extracted from medical records. Elements from the medical history, cognitive history, functional abilities, Modified Mini-Mental State (3MS) examination, Trails A/B, and clock drawing were included in the analysis. Four risk factors of interest were examined in separate logistic regression analyses, adjusted for demographic variables. Results: 50 participants were identified in each group. The R group was older on average than the NR. As expected, R were more likely to have Trails B scores over 3 min and have significantly abnormal clock drawing tests. R also showed lower 3MS scores and a higher average number of functional impairments (including managing appointments, medications, bills, or the television). Conclusion: Beyond standard cognitive tests, impairment in iADLs may help general practitioners identify at-risk drivers in the absence of standardized guidelines and tools. This finding can also inform the design of a risk assessment tool for driving and could help with approaches for drivers with otherwise borderline test results. |
| first_indexed | 2024-03-11T08:46:31Z |
| format | Article |
| id | doaj.art-02643f559ed940938d4f6e987cf17ecf |
| institution | Directory Open Access Journal |
| issn | 2308-3417 |
| language | English |
| last_indexed | 2024-03-11T08:46:31Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Geriatrics |
| spelling | doaj.art-02643f559ed940938d4f6e987cf17ecf2023-11-16T20:45:07ZengMDPI AGGeriatrics2308-34172023-01-0181710.3390/geriatrics8010007Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory ClinicFrank Knoefel0Shehreen Hossain1Amy T. Hsu2Bruyère Research Institute, Ottawa, ON K1N 5C8, CanadaBruyère Research Institute, Ottawa, ON K1N 5C8, CanadaBruyère Research Institute, Ottawa, ON K1N 5C8, CanadaBackground: Decisions around driving retirement are difficult for older persons living with cognitive decline and their caregivers. In many jurisdictions, physicians are responsible for notifying authorities of driving risks. However, there are no standardized guidelines for this assessment. Having access to a driving risk assessment tool could help older adults and their caregivers prepare for discussions around driving retirement. This study compares the clinical profiles of older adult drivers assessed in an academic memory clinic who were referred to the driving authority to older drivers who were not with a focus on instrumental activities of daily living (iADLs). Methods: Data on referred (R) and not-referred (NR) drivers were extracted from medical records. Elements from the medical history, cognitive history, functional abilities, Modified Mini-Mental State (3MS) examination, Trails A/B, and clock drawing were included in the analysis. Four risk factors of interest were examined in separate logistic regression analyses, adjusted for demographic variables. Results: 50 participants were identified in each group. The R group was older on average than the NR. As expected, R were more likely to have Trails B scores over 3 min and have significantly abnormal clock drawing tests. R also showed lower 3MS scores and a higher average number of functional impairments (including managing appointments, medications, bills, or the television). Conclusion: Beyond standard cognitive tests, impairment in iADLs may help general practitioners identify at-risk drivers in the absence of standardized guidelines and tools. This finding can also inform the design of a risk assessment tool for driving and could help with approaches for drivers with otherwise borderline test results.https://www.mdpi.com/2308-3417/8/1/7driving cessationcognitive declinequantitative datalogistic regressionfunction |
| spellingShingle | Frank Knoefel Shehreen Hossain Amy T. Hsu Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic Geriatrics driving cessation cognitive decline quantitative data logistic regression function |
| title | Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic |
| title_full | Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic |
| title_fullStr | Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic |
| title_full_unstemmed | Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic |
| title_short | Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic |
| title_sort | decline in other instrumental activities of daily living as indicators of driving risk in older adults at an academic memory clinic |
| topic | driving cessation cognitive decline quantitative data logistic regression function |
| url | https://www.mdpi.com/2308-3417/8/1/7 |
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