PREVALENCE AND FACTORS INFLEUENCING DRIVING CESSATION IN EARLY-ONSET ALZHEIMER’S DISEASE

Abstract

Driving impairment studies in Alzheimer's disease (AD) have focused mostly on older adults. Lesser is known about driving impairment in those with early onset AD (EOAD) (aged less than 65 years), which is vital for them to work, take their children to school and for their leisure activities. We aimed to evaluate the prevalence of driving cessation in EOAD referred to Younger Person's Memory Service (YPMS), a specialist service for young onset dementia and to establish factors influencing driving cessation in EOAD patients. The cross sectional study cohort consists of 64 EOAD patients who were former or current car-drivers (mean age 59.45 (±4.5) years, 39.1% females), who attended YPMS at the Leicestershire Partnership NHS Trust, East Midlands of England during 2000–2010. Reasons for driving cessation were assessed with the patients' caregivers. All patients were assessed for cognition, functional abilities and behaviour symptoms following a semi-structured interview. Cognitive functioning was determined by Mini-Mental State Examination (MMSE and the Cambridge cognitive Examination (CAMCOG), Bristol activities of daily living (BADL) for daily functioning, and behaviour by the Neuropsychiatric Inventory (NPI). 24 patients with EOAD stopped driving (37.5%) either voluntarily or after given the advice by clinicians or Driver and Vehicle Licensing Agency. Women were more likely to stop driving by themselves (52%). EOAD patients who ceased driving had lower scores on Mini Mental State Examination (p=0.010) and total CAMCOG (p=0.015). They also had significantly more deficits in remote memory (p=0.02), learning memory (p=0.036) and total praxis (p=0.009). Female gender and increasing impairment in cognitive abilities raise the probability of driving cessation in EOAD. These factors need to be considered when assessing driving abilities and counselling patient and families.