Driving cessation in older men with incident dementia.
OBJECTIVE
To determine the prevalence and cessation of driving among older men with incident dementia in the Honolulu-Asia Aging Study.


METHODS
Retrospective cohort data from a community-based study of incident dementia.


METHODS
The Honolulu Heart Program and the Honolulu-Asia Aging Study.


METHODS
A total of 643 men who were evaluated for the incidence of Alzheimer's disease or other dementia between the fourth and the fifth examination of the Honolulu Heart Program.


METHODS
Driving history, diagnosis of dementia, grip strength, walking speed, standing balance test, interviewer's rating of vision status, and the neurologist's notes on mentions of driving behavior from informal interviews with a caregiver or family informant.


RESULTS
The prevalence of driving declined dramatically with level of cognitive functioning. Among 162 men evaluated and found to have normal cognitive functioning, 78% still drove, compared with 62% of 287 men with poor cognitive functioning but no clinical dementia, 46% of 96 men with a new diagnosis of very mild dementia (Clinical Dementia Rating = 0.5), and 22% of 98 men with a new diagnosis of mild dementia (CDR = 1). Only one of 23 men diagnosed with moderate or more severe staged incident dementia (CDR > 1) was driving. About 10% of the 59 demented persons still driving relied on co-pilots, and only one driver was reported as involved in a crash according to a review of the neurologists' notes.


CONCLUSIONS
Incident dementia is a major cause of driving cessation. Based on these data, we estimate that approximately 4% of male drivers aged 75 years and older nationwide (about 175,000 men) have dementia. This number will increase with the projected growth of drivers aged 75 years and older.
Foley
D J
DJ
Epidemiology, Demography and Biometry Program, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892, USA.
Masaki
K H
KH
Ross
G W
GW
White
L R
LR
D000203:Activities of Daily Living; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000523:psychology / Q000706:statistics & numerical data*; D003071:Cognition; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015577:Geriatric Assessment; D018737:Hand Strength; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016138:Walking