Why older people stop to drive? A cohort study of older patients admitted to a rehabilitation setting

  • Christian Pozzi
  • Elena Lucchi
  • Alessandro Lanzoni
  • Simona Gentile
  • Sara Morghen
  • Marco Trabucchi
  • Giuseppe Bellelli
  • Alessandro Morandi
Short Communication

Abstract

The aim of this study is to describe the predictive factors of driving cessation at 6-month follow-up in older patients discharged from a rehabilitation setting and evaluated by an occupational therapist in a multidisciplinary team. Of 95 patients, at 6-month 27.4% ceased to drive. The reasons for driving cessation were a patients’ voluntary choice (42.3%) or a choice of their family (23.1%), and only in 34.6% of the patients the license was revoked by a medical commission. In a multivariate analysis greater functional impairment—measured with the Timed Up and Go test—(OR 12.60, CI 2.74–57.89; p < 0.01) was the only predictor of driving cessation. This study shows that the ability to walk safely and independently is a significant predictor of driving cessation. The simple assessment of this factor using the TUG might be an easy screening tool to prompt a second level evaluation to accurately identify unsafe driving.

Keywords

Driving Older adults Age Functional impairment Occupational therapy 

Supplementary material

40520_2017_804_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 17 KB)
40520_2017_804_MOESM2_ESM.docx (18 kb)
Supplementary material 2 (DOCX 18 KB)

References

  1. 1.
    Bernabei R, Landi F, Zuccala G (2002) Health care for older persons in Italy. Aging Clin Exp Res 14:247–251CrossRefPubMedGoogle Scholar
  2. 2.
    Dawson JD, Uc EY, Anderson SW et al (2010) Neuropsychological predictors of driving errors in older adults. J Am Geriatr Soc 58:1090–1096. doi:10.1111/j.1532-5415.2010.02872.x CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Iverson DJ, Gronseth GS, Reger MA et al. (2010) Practice parameter update: evaluation and management of driving risk in dementia: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 74:1316–1324. doi:10.1212/WNL.0b013e3181da3b0f CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    McGwin G Jr, Sims RV, Pulley L et al. (2000) Relations among chronic medical conditions, medications, and automobile crashes in the elderly: a population-based case–control study. Am J Epidemiol 152:424–431CrossRefPubMedGoogle Scholar
  5. 5.
    Brown LB, Ott BR, Papandonatos GD et al. (2005) Prediction of on-road driving performance in patients with early Alzheimer’s disease. J Am Geriatr Soc 53:94–98. doi:10.1111/j.1532-5415.2005.53017.x CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    O’Connor MG, Kapust LR, Lin B et al. (2010) The 4Cs (crash history, family concerns, clinical condition, and cognitive functions): a screening tool for the evaluation of the at-risk driver. J Am Geriatr Soc 58:1104–1108. doi:10.1111/j.1532-5415.2010.02855.x CrossRefPubMedGoogle Scholar
  7. 7.
    Ott BR, Davis JD, Papandonatos GD et al. (2013) Assessment of driving-related skills prediction of unsafe driving in older adults in the office setting. J Am Geriatr Soc 61:1164–1169. doi:10.1111/jgs.12306 CrossRefPubMedGoogle Scholar
  8. 8.
    Royall DR, Cordes JA, Polk M (1998) CLOX: an executive clock drawing task. J Neurol Neurosurg Psychiatry 64:588–594CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142–148CrossRefPubMedGoogle Scholar
  10. 10.
    Niewoehner PM, Henderson RR, Dalchow J et al. (2012) Predicting road test performance in adults with cognitive or visual impairment referred to a Veterans Affairs Medical Center driving clinic. J Am Geriatr Soc 60:2070–2074. doi:10.1111/j.1532-5415.2012.04201.x PubMedGoogle Scholar
  11. 11.
    Studenski S, Perera S, Patel K et al. (2011) Gait speed and survival in older adults. JAMA 305:50–58. doi:10.1001/jama.2010.1923 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Middleton A, Fritz SL, Lusardi M (2015) Walking speed: the functional vital sign. J Aging Phys Act 23:314–322. doi:10.1123/japa.2013-0236 CrossRefPubMedGoogle Scholar
  13. 13.
    Aboutorabi A, Arazpour M, Bahramizadeh M et al. (2016) The effect of aging on gait parameters in able-bodied older subjects: a literature review. Aging Clin Exp Res 28:393–405. doi:10.1007/s40520-015-0420-6 CrossRefPubMedGoogle Scholar
  14. 14.
    Rizzo M (2011) Impaired driving from medical conditions: a 70-year-old man trying to decide if he should continue driving. JAMA 305:1018–1026. doi:10.1001/jama.2011.252 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Shimada H, Makizako H, Tsutsumimoto K et al. (2016) Driving and incidence of functional limitation in older people: a prospective population-based study. Gerontology 62(6):636–643. doi:10.1159/000448036 CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Rehabilitation and Aged Care “Fondazione Camplani” HospitalCremonaItaly
  2. 2.Rehabilitation Hospital Ancelle di CremonaGeriatric Research GroupBresciaItaly
  3. 3.Geriatric Centre “Fondazione Boni”Suzzara (MN)Italy
  4. 4.School of Medicine and SurgeryUniversity of Milano-BicoccaMilanItaly
  5. 5.Geriatric UnitS. Gerardo HospitalMonzaItaly

Personalised recommendations