TY - JOUR
T1 - Family reports of medically impaired drivers in Missouri
T2 - Cognitive concerns and licensing outcomes
AU - Meuser, Thomas M.
AU - Carr, David B.
AU - Unger, Elizabeth A.
AU - Ulfarsson, Gudmundur F.
N1 - Funding Information:
The authors thank the University of Iceland Research Fund for supporting this research. The authors also thank the AAA Foundation for Traffic Safety and the Washington University Friedman Center for Aging NIA Grant K07AG21164 that in part funded the original research project from which the present data were derived.
Publisher Copyright:
© 2014 Elsevier Ltd. All rights reserved.
PY - 2014
Y1 - 2014
N2 - 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.
AB - 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.
KW - Aging
KW - Alzheimer's disease
KW - Dementia
KW - Family input
KW - Fitness-to-drive
KW - Medical impairments
KW - Older drivers
UR - http://www.scopus.com/inward/record.url?scp=84908362041&partnerID=8YFLogxK
U2 - 10.1016/j.aap.2014.10.002
DO - 10.1016/j.aap.2014.10.002
M3 - Article
C2 - 25463940
AN - SCOPUS:84908362041
SN - 0001-4575
VL - 74
SP - 17
EP - 23
JO - Accident Analysis and Prevention
JF - Accident Analysis and Prevention
ER -