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O3‐07‐01: Monitoring drivers with dementia: An instrumented vehicle study
Author(s) -
Silverstein Nina M.,
Eby David W.,
Molnar Lisa J.,
LeBlanc David J.,
Adler Geri
Publication year - 2009
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2009.05.475
Subject(s) - dementia , psychomotor learning , perception , cognition , psychology , disease , applied psychology , medicine , psychiatry , pathology , neuroscience
Background: Dementia affects many critical skills needed for driving including memory, judgment, psychomotor abilities, perception and visual processing, attention, and the ability to make accurate decisions and to control impulses when pressured to act in a traffic situation. Research has yet to determine the level of cognitive impairment associated with an unacceptable driving risk. Up to 45% of persons with AD continue to drive, especially early in the disease when cognitive deficits are mild. However, as the disease progresses driving skills progressively worsen. Physicians and other health care professionals are often faced with making recommendations about their patients’ fitness to drive based on driver selfscreening, recommendations by family members, and, if available, formal driving assessment. Follow-up as the disease progresses ranges from 3 months to a year. Yet, no one really understands how the real-life driving performance of an individual changes within assessment intervals. If the interval is too short, it places an undue burden on the individual and his or her family. If it is too long, the individual may pose a threat to public safety as well as to his or her own safety. Recent advances in technology can be used to monitor the driving behavior of individuals with dementia and provide guidance on how often these drivers need to be assessed, and the validity of recommendations of clinicians, family, and self-screening. Methods: The perspectives of 12 triads (persons with dementia, family members, and driving specialists) were compared to empirical data on on-road performance gained through in-vehicle monitoring of the drivers’ own cars for at least one month. An interdisciplinary team examined the complexity of the criteria considered in this highly-charged, emotional, and life-changing decision. Results: Research demonstrated the feasibility of using in-vehicle data collection to monitor driving actions of persons with early-stage dementia; compared the validity of multiple forms of assessment of driving skills with naturalistic driving; and provided insights to better inform decision-makers about appropriate intervals for checking driving competency. Conclusions: The findings bring greater visibility to deficits in driving performance unique to people with early-stage dementia through increased understanding of the behaviors and challenges confronting them.