Dement Neurocogn Disord.  2014 Dec;13(4):83-88. 10.12779/dnd.2014.13.4.83.

Driving in Patients with Dementia: A CREDOS (Clinical Research Center for Dementia of South Korea) Study

Affiliations
  • 1Department of Neurology, Inha University School of Medicine, Incheon, Korea. seonghye@inha.ac.kr
  • 2Department of Neurology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
  • 3Department of Neurology, Konyang University College of Medicine, Daejeon, Korea.
  • 4Department of Neurology, Seoul Veterans Hospital, Seoul, Korea.
  • 5Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 6Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND
There are few studies about driving and dementia in Korea. The purpose of this study is to investigate the real condition of automobile driving in patients with dementia and the characteristics of those who continue to drive after diagnosis of dementia.
METHODS
A total of 4,377 patients including 3,792 with Alzheimer's disease and 585 with vascular dementia were recruited from multiple nationwide hospitals. Clinical evaluations and neuropsychological tests were done in them according to the protocol of the Clinical Research Center for Dementia of South Korea study. Caregivers replied which patients drove an automobile, gave up driving, or has never driven. The same evaluations of them were followed after one year.
RESULTS
There were 272 (6.2%) drivers, 321 (7.3%) ex-drivers, and 3,784 (86.5%) non-drivers with dementia. Drivers with dementia were younger and had higher Korean Mini-Mental State Examination (K-MMSE) (21.5+/-4.3 vs 19.8+/-5.1 vs 17.4+/-5.2, p<0.001) and lower Clinical Dementia Rating scale-Sum of Boxes (CDR-SB) scores (4.08+/-2.15 vs 5.80+/-3.41 vs 5.83+/-3.39, p<0.001) compared with ex-drivers and non-drivers with dementia. The drivers and ex-drivers with dementia had higher educational level and a higher proportion of male compared with non-drivers with dementia (77.6% vs 80.1% vs 23.3%, p<0.001). About 54.6% of the drivers with dementia continued to drive at one year after diagnosis of dementia. They had higher K-MMSE (23.2+/-3.6 vs 20.8+/-4.5, p=0.003) and lower CDR-SB scores (3.30+/-1.47 vs 4.40+/-1.85, p=0.001) at baseline compared with those who quitted driving after baseline.
CONCLUSIONS
Male patients who were relatively young and had high educational level and mild dementia had a tendency to drive an automobile at that time of diagnosis of dementia. About half of them continued to drive after diagnosis of dementia.

Keyword

Driving; Dementia; Alzheimer disease; Vascular dementia

MeSH Terms

Alzheimer Disease
Automobile Driving
Automobiles
Caregivers
Dementia*
Dementia, Vascular
Diagnosis
Humans
Korea
Male
Neuropsychological Tests

Reference

1. Eby DW, Silverstein NM, Molnar LJ, LeBlanc D, Adler G. Driving behaviors in early stage dementia: a study using in-vehicle technology. Accid Anal Prev. 2012; 49:330–337.
Article
2. Breen DA, Breen DP, Moore JW, Breen PA, O'Neill D. Driving and dementia. BMJ. 2007; 334:1365–1369.
Article
3. Iverson DJ, Gronseth GS, Reger MA, Classen S, Dubinsky RM, Rizzo M, et al. Practice parameter update: evaluation and management of driving risk in dementia: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010; 74:1316–1324.
Article
4. Dawson JD, Anderson SW, Uc EY, Dastrup E, Rizzo M. Predictors of driving safety in early Alzheimer disease. Neurology. 2009; 72:521–527.
Article
5. Cutler SJ. Transport changes in life satisfaction. Gerontologist. 1975; 15:155–159.
6. Marottoli RA, de Leon CFM, Glass TA, Williams CS, Cooney LM Jr, Berkman LF. Consequences of driving cessation: decreased out-of-home activity levels. J Gerontol B Psychol Sci Soc Sci. 2000; 55:S334–S340.
7. Ragland DR, Satariano WA, MacLeod KE. Driving cessation and increased depressive symptoms. J Gerontol A Biol Sci Med Sci. 2005; 60:399–403.
8. Adler G, Kuskowski M. Driving cessation in older men with dementia. Alzheimer Dis Assoc Disord. 2003; 17:68–71.
9. Carmody J, Carey M, Potter J, Marchetti E, Traynor V, Iverson D. Driving with dementia: Equity, obligation, and insurance. Australas Med J. 2014; 7:384–387.
Article
10. Carter K, Monaghan S, O'Brien J, Teodorczuk A, Mosimann U, Taylor JP. Driving and dementia: a clinical decision pathway. Int J Geriatr Psychiatry. 2014; [Epub ahead of print].
Article
11. Choi SH, Kim S, Han SH, Na DL, Kim DK, Cheong HK, et al. Neurologic signs in relation to cognitive function in subcortical ischemic vascular dementia: a CREDOS (Clinical Research Center for Dementia of South Korea) study. Neurol Sci. 2012; 33:839–846.
Article
12. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association;1994.
Article
13. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDSADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease. Neurology. 1984; 34:939–944.
Article
14. Román GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology. 1993; 43:250–260.
Article
15. Noh Y, Lee Y, Seo SW, Jeong JH, Choi SH, Back JH, et al. A new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities. J Stroke Cerebrovasc Dis. 2014; 23:636–642.
Article
16. Ku HM, Kim J, Kwon EJ, Kim SH, Lee HS, Ko H, et al. A study on the reliability and validity of Seoul-instrumental activities of daily living. J Korean Neuropsychiatr Assoc. 2004; 43:189–199.
Article
17. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965; 14:61–65.
Article
18. Han C, Jo SA, Jo I, Kim E, Park MH, Kang Y. An adaptation of the Korean mini-mental state examination (K-MMSE) in elderly Koreans: demographic influence and population-based norms (the AGE study). Arch Gerontol Geriatr. 2008; 47:302–310.
Article
19. Ahn HJ, Chin J, Park A, Lee BH, Suh MK, Seo SW, et al. Seoul Neuropsychological Screening Battery-dementia version (SNSB-D): a useful tool for assessing and monitoring cognitive impairments in dementia patients. J Korean Med Sci. 2010; 25:1071–1076.
Article
20. Bae JN, Cho MJ. Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. J Psychosom Res. 2004; 57:297–305.
Article
21. Choi SH, Lee BH, Kim S, Hahm DS, Jeong JH, Yoon SJ, et al. Interchanging scores between clinical dementia rating scale and global deterioration scale. Alzheimer Dis Assoc Disord. 2003; 17:98–105.
22. Hachinski VC, Iliff LD, Zilhka E, Du Boulay GH, McAllister VL, Marshall J, et al. Cerebral blood flow in dementia. Arch Neurol. 1975; 32:632–637.
23. Yoon B, Shim YS, Kim Y, Lee KO, Na S, Hong Y, et al. Who takes care of patients with dementia in Korea: a study on the present state of patients with dementia living alone and primary caregivers. Dement Neurocogn Disord. 2012; 11:13–17.
Article
24. Kim SR, Hwang H, Kim S, Choi Y, Song C, Kim I, et al. Effect of Physical Disability on Instrumental Activities of Daily Living in Alzheimer's Disease, Amnestic Mild Cognitive Impairment (MCI), and Vascular Dementia and Vascular MCI of Subcortical Type. J Korean Neurol Assoc. 2009; 27:355–361.
Article
25. Marie Dit, Fabrigoule C, Helmer C, Laumon B, Lafont S. Automobile driving in older adults: factors affecting driving restriction in men and women. J Am Geriatr Soc. 2014; 62:2071–2078.
26. O'Bryant SE, Lacritz L, Hall J, Waring SC, Chan W, Khodr ZG, et al. Validation of the new interpretive guidelines for the clinical dementia rating scale sum of boxes score in the national Alzheimer's coordinating center database. Arch Neurol. 2010; 67:746–749.
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