title: Gender effect on driving cessation in pre-dementia and dementia phases: results of the 3C population-based study.
abstract: OBJECTIVE
  Aging entails deterioration in sensory, physical, and cognitive functions, raising doubt in the driving capacity of older drivers, especially when the deficits are severe, as in dementia. Many older drivers, especially women, adapt their driving habits in order to compensate for these deficits and eventually stop driving. The present prospective study assessed driving cessation in men and women throughout the dementia process, including a 2-year pre-dementia phase.
  
  
  METHODS
  The study was based on a three-city cohort of subjects who were aged 65 years and older in 2000 and followed for more than 10 years. Active dementia detection was conducted at each follow-up. The probability of driving cessation was assessed in men and women during the 2-year pre-dementia phase and until 5 years after diagnosis.
  
  
  RESULTS
  In the 2-year pre-dementia phase, both men and women ceased driving earlier than drivers with no central nervous system pathology (p < 0,001), and women ceased driving earlier than men. A total of 45% of men and 74% of women had already ceased driving at dementia diagnosis. In contrast, the probability of cessation within 3 years after diagnosis was similar between men and women.
  
  
  CONCLUSIONS
  The study showed that, in this French urban population, few demented drivers, especially women, were still driving after diagnosis. Those who continued to drive 3 years after the diagnosis all had Alzheimer-type dementia. There is certainly a need for physicians to help these drivers to adapt their driving activity to their deficits and to prepare them to stop driving. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, Bron, France.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Marie Dit Asse
authors.affiliation: USR 3413 CNRS/Université Bordeaux Segalen, Bordeaux cedex, France.
authors.forename: Colette
authors.initials: C
authors.lastname: Fabrigoule
authors.affiliation: Centre INSERM U897-Epidemiologie-Biostatistique, ISPED, Bordeaux, France.
authors.forename: Catherine
authors.identifier: http://orcid.org/0000-0002-5169-7421
authors.initials: C
authors.lastname: Helmer
authors.affiliation: Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, Bron, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Laumon
authors.affiliation: INSERM U1061 - Hôpital La Colombière, Montpellier Cedex 5, France.
authors.forename: Claudine
authors.initials: C
authors.lastname: Berr
authors.affiliation: Centre Mémoire de Ressources et de Recherche, Bocage Central, Dijon, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Rouaud
authors.affiliation: Centre Mémoire de Ressources et de Recherche, Bordeaux Cedex, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Auriacombe
authors.affiliation: Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, Bron, France.
authors.forename: Sylviane
authors.initials: S
authors.lastname: Lafont
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000706:statistics & numerical data*; D003072:Cognition Disorders / Q000150:complications*; D003704:Dementia / Q000150:complications*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014505:Urban Population / Q000706:statistics & numerical data
keywords: cohort study; dementia; driving cessation; gender; older drivers; pre-dementia