<p>Driver Self-Regulation Practices in Older Drivers with and Without Mild Cognitive Impairment</p>

Feng, Ying Ru; Meuleners, Lynn; Stevenson, Mark; Heyworth, Jane; Murray, Kevin; Maher, Sean · 2020 · OpenAlex-citations

DOI: 10.2147/cia.s236998

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Summary

This study investigates the impact of cognitive status, socio-demographic factors, and driving characteristics on self-regulation practices among older drivers, specifically comparing those with mild cognitive impairment (MCI) to those with no cognitive impairment. The research is motivated by the growing aging population and the associated increase in road crash fatality rates for drivers aged 75 and older. While driver self-regulation—modifying behavior to avoid challenging situations—is a critical safety strategy, concerns exist that MCI may impair the insight necessary for such adjustments. The study aims to determine if drivers with MCI recognize their limitations and adjust their driving accordingly, particularly in complex scenarios. The researchers conducted a cross-sectional study involving 973 drivers aged 65 and older living in Western Australia between November 2018 and February 2019. Participants were recruited from a database of older drivers and screened using the Telephone Cognitive Screen (T-CogS). Drivers scoring 21–24 were classified as having MCI (n=362), while those scoring 25–26 were classified as having no cognitive impairment (n=611). Data were collected via structured telephone interviews assessing socio-demographics, health status, and self-reported avoidance of nine specific driving situations over the past three months, such as driving at night, in rain, or making turns across oncoming traffic. Statistical analyses included chi-square tests and multivariate logistic regression to examine associations between cognitive status and self-regulation. The results indicate that the majority of drivers in both groups engaged in self-regulation: 62.4% of drivers with MCI and 57.1% of those without impairment reported avoiding at least one driving situation. The most common avoided situations for both groups included driving at night in the rain, parallel parking, and driving in the rain. However, drivers with MCI were significantly more likely to self-regulate when making turns across oncoming traffic and driving at night. Multivariate analysis revealed that drivers with MCI had 39% greater odds of self-regulating in at least one situation compared to those without impairment (OR: 1.39, 95% CI: 1.04–1.85). Additionally, female drivers had 2.3 times greater odds of self-regulation, and drivers aged 75 and older had 1.6 times greater odds compared to those aged 65–69. The study concludes that older drivers with MCI are more likely to self-regulate their driving, particularly in complex situations, suggesting that many can recognize their cognitive limitations and adjust behavior to maintain safety. However, the finding that several drivers with MCI, particularly males, did not self-regulate highlights a potential safety risk. The authors emphasize the importance of advising patients with MCI about the impact of their condition on driving ability, promoting suitable self-regulation strategies, and monitoring their driving performance to mitigate crash risks.

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Topics

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• mci dementia driving
• cognitive impairment
• older drivers
• cognitive capacity variation