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Driving: The super-activity of daily living?

Driving is a complex task that involves many different skills and body functions. To drive safely we need to integrate our visual, cognitive, physical, and perceptual skills. We’ve asked Dr. Brenda Vrkljan to talk about how cognitive decline can impact a person’s ability to drive safely and how healthcare professionals can help evaluate a person’s fitness to drive and support them in maintaining their mobility and independence for as long as possible.

 

Learn the answers to the following questions:

  • How should a person's fitness to drive be assessed?
  • What evidence links cognitive assessment tools, like clock-drawing tests, to medical fitness to drive?
  • What other cognitive assessments may be done?
  • What are signs someone should consider stopping driving?
  • What are some of the downsides to stopping driving?
  • What should be considered when driving may no longer be an option?

 

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References

  1. McMaster Optimal Aging Portal. What does drawing clocks have to do with driving cars? Tests of cognitive skills that can flag older drivers who may be unsafe behind the wheel (2016 May 25). Accessed September 15, 2021. Available from: https://www.mcmasteroptimalaging.org/blog/detail/blog/2016/05/25/what-does-drawing-clocks-have-to-do-with-driving-cars-tests-of-cognitive-skills-that-can-flag-older-drivers-who-may-be-unsafe-behind-the-wheel
  2. Turcotte, M. Profile of seniors' transportation habits. Can Soc Trends. 2012;93: 1-16.
  3. Canadian Medical Association. (2019). Determining medical fitness to drive: A guide for physicians (9th ed.) (2019 Oct). Accessed September 15, 2021. Available from: https://www.schulich.uwo.ca/geriatrics/docs/CMA_Drivers_Guide_9th_edition.pdf
  4. Hopkins RW, Kilik L, Day DJA, Rows C, Tseng H. Driving and dementia in Ontario: A quantitative assessment of the problem. Can J Psychiatry. 2004;49(7):434-438.
  5. Freund B, Gravenstein S, Ferris R, Burke BL, Shaheen E. Drawing clocks and driving cars: Use of brief tests of cognition to screen driving competency in older adults. J Gen Intern Med. 2005;20(3):240-244.
  6. Oswanski MF, Sharma OP, Raj SS, et al. Evaluation of two assessment tools in predicting driving ability of senior drivers. Am J Phys Med Rehabil. 2007;86(3): 190-199.
  7. Carr DB, Barco PP, Wallendorf MJ, Snellgrove CA, Ott BR. Predicting Road test performance in drivers with dementia. J Am Geriatr Soc. 2011;59(11):2112-2117.
  8. De Raedt R, Ponjaert-Kristoffersen I. Short cognitive/ neuropsychological test battery for first-tier fitness-to-drive assessment of older adults. The Clinical Neuropsychologist. 2001;15(3), 329-336.
  9. Ontario Ministry of Transportation. Renew a G driver’s licence: 80 years and over. (2013 Jun 5). Accessed September 15, 2021. Available from: https://www.ontario.ca/driving-and-roads/renew-g-drivers-licence-80-years-and-over
  10. Fonda SJ, Wallace RB, Herzog AR. Changes in driving patterns and worsening depressive symptoms among older adults. J Gerontol. 2001.; 56(6):S343-351.
  11. Marottoli RA, de Leon CFM, Glass TA. Consequences of driving cessation: decreased out-of-home activity levels. J Gerontol B Psychol Sci Soc Sci. 2000; 55:S334-340.
  12. Freeman EE, Gange SJ, Munoz B, Wet SK. Driving status and risk of entry into long term care in older adults. Am J Public Health. 2006;96:1254-1259.
  13. Chihuri SC, Mielenz TJ, DiMaggio CJ, et al. Driving cessation and health outcomes in older adults. J Am Geriatr Soc. 2016 Jan; 64:332– 341.
  14. Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-9.
  15. Tombaugh TN. Trail Making Test A and B: normative data stratified by age and education. Arch Clin Neuropsychol. 2004;19(2):203-14.
  16. Helmes E. Cognitive screening of older adults: the utility of pentagon drawing. Int Psychogeriatr. 2013;25(3):413-9.
  17. Lee L, Molnar F. Driving and dementia: Efficient approach to driving safety concerns in family practice. Can Fam Physic. 2017 Jan; 63:27-31.

Acknowledgements

This work is supported through the McMaster Institute for Research on Aging and funds provided by the Dean and Vice-President, Faculty of Health Sciences at McMaster University. 

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of these blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations such as social distancing and frequent hand washing. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with current social distancing recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.

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