Driving and dementia of the Alzheimer type: beliefs and cessation strategies among stakeholders.
OBJECTIVE
Although driving by persons with Alzheimer's disease (AD) is an important public health concern, we know little about the attitudes and perceptions of key stakeholders regarding driving safety in these individuals or the factors that precipitate and influence driving assessment and cessation decisions.


METHODS
We convened 10 focus groups composed of persons intimately involved in driving decisions for older adults to identify and compare beliefs and perceptions concerning AD and driving and to identify effective strategies to limit or cease unsafe driving. The 68 focus-group participants included health professionals, transportation and law-enforcement professionals, current and former drivers with AD, and family caregivers of current and former drivers with the disease.


RESULTS
With few exceptions, participants said that a diagnosis of very mild AD alone did not preclude driving. Most regarded family members as pivotal in monitoring and managing unsafe driving and recognized their need for institutional and medical support, especially support from physicians in counseling and evaluation of health-related fitness of older drivers. Members of each group acknowledged their own roles and responsibilities in driving decisions and described difficulties they experienced in making assessments and implementing decisions to limit or stop the driving of given individuals with AD.


CONCLUSIONS
Education of families, professionals, and transportation specialists is needed to understand the influence of AD severity on driving abilities, identify problem driving behaviors, make appropriate referrals of unsafe drivers, and access available resources for drivers with AD and those most responsible for their safety.
Perkinson
Margaret A
MA
Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO 63108, USA.
Berg-Weger
Marla L
ML
Carr
David B
DB
Meuser
Thomas M
TM
Palmer
Janice L
JL
Buckles
Virginia D
VD
Powlishta
Kimberly K
KK
Foley
Daniel J
DJ
Morris
John C
JC
D000063:Accidents, Traffic / Q000517:prevention & control; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology*; D001291:Attitude of Health Personnel; D001334:Automobile Driving; D017028:Caregivers / Q000523:psychology*; D003469:Culture; D017144:Focus Groups; D006801:Humans; D016743:Mental Competency; D012449:Safety; D014481:United States