Family reports of medically impaired drivers in Missouri: Cognitive concerns and licensing outcomes

Thomas M. Meuser, David B. Carr, Elizabeth A. Unger, Gudmundur F. Ulfarsson

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


This study investigated reasons why older adults (n = 689) were reported to the Driver License Bureau, Missouri Department of Revenue, by family members as potentially unfit to drive with an emphasis on cognitive concerns and associated licensing outcomes. A total of 448 drivers were reported to have some cognitive issue; common symptoms included confusion, memory loss, and becoming lost while driving. Diagnostic labels (Alzheimer's disease (AD), cognitive impairment/dementia, brain injury/insult) were listed for 365 cases. A physician evaluation is required for license review. Of those with a diagnostic label, half (51%, n = 187) failed to submit this evaluation and almost all were de-licensed immediately. Of those evaluated by a physician, diagnostic agreement between family members and physicians was high for specific conditions (100% for AD, 97% for acute brain injury), and less so for cognitive impairment/dementia (75%). This latter finding suggests that physicians and family members may understand cognitive symptoms differently. Whether cognitively impaired or not, few family reported drivers in this sample (∼2%) retained a valid license. Family members may be in the best position to recognize when medical-functional deficits impact on driving safety, and physicians and driver licensing authorities would do well to take their observations into account with respect to older driver fitness.

Original languageEnglish
Pages (from-to)17-23
Number of pages7
JournalAccident Analysis and Prevention
StatePublished - 2014


  • Aging
  • Alzheimer's disease
  • Dementia
  • Family input
  • Fitness-to-drive
  • Medical impairments
  • Older drivers


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