Driving ability in people with dementia
Bouman, Walter P.
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Background: Previous research has suggested that patients with dementia are impaired at driving relative to normal individuals (betaieliauskas, 2005). As well as identifying a cognitive test battery for predicting safety to drive in people with dementia, we aimed to determine particular driving difficulties experienced by those with dementia. We also aimed to discover whether their performance on the road was related to cognitive abilities. Methods: We re-cruited participants with dementia who were driving and had a diagnosis of dementia, and a comparison control group with no known memory problems. All participants completed a battery of cognitive tests, and were then assessed on the Nottingham Neurological Driving Assessment by an Approved Driving Instructor who was blind to the cognitive test results. This comprised 25 items upon which the driver was scored. Results: 118 patients with dementia and 30 controls completed the whole study. Of the patients with dementia, 27 were unsafe and 91 safe on the road, whilst all controls were safe. Relative to controls, patients with de-mentia were significantly worse at: observations to rear (p = 0.016); driving in traffic lanes (p = 0.039); and obedience of road signs (p = 0.018). Within the group with dementia (n = 118) road performance correlated significantly with four cognitive tests: SDSA Road Sign Rec-ognition (p < 0.001); SDSA Square Matrices Directions (p < 0.05); MMSE (p = 0.001); and BADS Key Search (p < 0.05). Conclusions: Whilst no control participants failed their on road assessment, 22.9% of the patients with dementia did, showing particular difficulty on three measures. Performance on the road correlated well with performance on four cognitive tests. This is consistent with the finding that the battery of cognitive tests successfully predicted safety to drive in patients with dementia.