Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic.
Autor: | Knoefel F; Bruyère Research Institute, Ottawa, ON K1N 5C8, Canada.; Bruyère Continuing Care, Ottawa, ON K1N 5C8, Canada.; Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada.; Department of Systems and Computer Engineering, Faculty of Engineering and Design, Carleton University, Ottawa, ON K1S 5B6, Canada.; AGE-WELL NIH-SAM3, Ottawa, ON K1N 5C8, Canada., Hossain S; Bruyère Research Institute, Ottawa, ON K1N 5C8, Canada.; Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada., Hsu AT; Bruyère Research Institute, Ottawa, ON K1N 5C8, Canada.; Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada.; Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada. |
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Jazyk: | angličtina |
Zdroj: | Geriatrics (Basel, Switzerland) [Geriatrics (Basel)] 2023 Jan 05; Vol. 8 (1). Date of Electronic Publication: 2023 Jan 05. |
DOI: | 10.3390/geriatrics8010007 |
Abstrakt: | Background: Decisions around driving retirement are difficult for older persons living with cognitive decline and their caregivers. In many jurisdictions, physicians are responsible for notifying authorities of driving risks. However, there are no standardized guidelines for this assessment. Having access to a driving risk assessment tool could help older adults and their caregivers prepare for discussions around driving retirement. This study compares the clinical profiles of older adult drivers assessed in an academic memory clinic who were referred to the driving authority to older drivers who were not with a focus on instrumental activities of daily living (iADLs). Methods: Data on referred (R) and not-referred (NR) drivers were extracted from medical records. Elements from the medical history, cognitive history, functional abilities, Modified Mini-Mental State (3MS) examination, Trails A/B, and clock drawing were included in the analysis. Four risk factors of interest were examined in separate logistic regression analyses, adjusted for demographic variables. Results: 50 participants were identified in each group. The R group was older on average than the NR. As expected, R were more likely to have Trails B scores over 3 min and have significantly abnormal clock drawing tests. R also showed lower 3MS scores and a higher average number of functional impairments (including managing appointments, medications, bills, or the television). Conclusion: Beyond standard cognitive tests, impairment in iADLs may help general practitioners identify at-risk drivers in the absence of standardized guidelines and tools. This finding can also inform the design of a risk assessment tool for driving and could help with approaches for drivers with otherwise borderline test results. |
Databáze: | MEDLINE |
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