Driving with Mild Cognitive Impairment or Dementia: Cognitive Test Performance and Proxy Report of Daily Life Function in Older Women.
OBJECTIVE
To investigate associations between proxy report of cognitive and functional limitations and cognitive performance and current or former driving status in older women with mild cognitive impairment (MCI) and all-cause dementia.


METHODS
Cross-sectional data analysis of retrospectively identified older women with adjudicated MCI and all-cause dementia in the Women's Health Initiative Memory Study-Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO).


METHODS
Academic medical center.


METHODS
Women (mean age ± standard deviation 83.7 ± 3.5) adjudicated with MCI or dementia during Year 1, 2, 3, or 4 of the WHIMS-ECHO follow-up period (N = 385).


METHODS
The telephone-administered cognitive battery included tests of attention, verbal learning and memory, verbal fluency, executive function, working memory, and global cognitive function plus self-report measures of depressive symptomatology. The Dementia Questionnaire (DQ) was administered to a knowledgeable proxy (family member, friend).


RESULTS
Sixty percent of women with MCI and 40% of those with dementia are current drivers. Proxy reports of functional limitations in instrumental activities of daily living (IADLs) are associated with current driving status in women with MCI, whereas performance-based cognitive tests are not. In women with dementia, proxy reports of functional limitations in IADLs and performance-based cognitive tests are associated with current driving status, as expected.


CONCLUSIONS
These findings have clinical implications for the importance of evaluating driving concurrently with other instrumental functional abilities in MCI and dementia. Additional work is needed to determine whether proxy report of cognitive and functional impairments should help guide referrals for driving assessment and rehabilitation or counseling for driving transition.
Department of Social Sciences and Health Policy, Wake Forest University, Winston-Salem, North Carolina.
Leslie
L
Vaughan
Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, North Carolina.
Patricia E
PE
Hogan
Department of Social Sciences and Health Policy, Wake Forest University, Winston-Salem, North Carolina.|Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, North Carolina.
Stephen R
SR
Rapp
Department of Gerontology, McCormack Graduate School for Policy and Global Studies, University of Massachusetts Boston, Boston, Massachusetts.
Elizabeth
E
Dugan
School of Medicine, Yale University, New Haven, Connecticut.|Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
Richard A
RA
Marottoli
Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, North Carolina.
Beverly M
BM
Snively
Department of Social Sciences and Health Policy, Wake Forest University, Winston-Salem, North Carolina.
Sally A
SA
Shumaker
Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
Kaycee M
KM
Sink
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving; D060825:Cognitive Dysfunction / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000503:physiopathology*; D005260:Female; D006801:Humans; D019727:Proxy; D011581:Psychological Tests
aging; dementia; driving; instrumental activities of daily living; mild cognitive impairment