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Abstract
Previous studies have suggested that the pattern of cognitive impairment in crash-involved older drivers is different from non-crash-involved older drivers. This study assessed the relationship between seven areas of cognitive functioning (orientation to time, orientation to place, registration, attention and calculation, recall, language, and visual construction) on the Mini-Mental State Examination (MMSE) collected at baseline and rates of future crash involvement in a prospective population-based sample of older drivers. Motor vehicle collision (MVC) involvement was obtained from the Alabama Department of Public Safety. Poisson regression was used to calculate crude and adjusted rate ratios (RR). Older drivers having difficulties in place orientation were more than 6 times (95% CI 1.90–19.86) more likely to be involved in a future crash (adjusted RR = 6.14, 95% confidence interval (CI) 1.90–19.86) and at-fault crash (adjusted RR = 6.39, 95% CI 1.51–27.10). Impairment in the other cognitive areas was not associated with higher rates of crash or at-fault crash involvement. The findings were validated in an independent sample of high-risk older drivers and a similar pattern of results was observed. Spatial orientation impairment can help identify older drivers who are more likely to crash in the future.
Highlights
There are currently about 32 million adults aged 70 years and older in the United States with over 80% of them licensed to drive [1,2]
Our results suggest that impairment in the orientation to place domain is germane to understanding crash risk in older drivers
Results from the current study suggest that noting the areas in which patients “lose” their points on the Mini-Mental State Examination (MMSE) may assist with identifying high-risk older drivers
Summary
There are currently about 32 million adults aged 70 years and older in the United States with over 80% of them licensed to drive [1,2]. 240,000 injured in motor vehicle traffic crashes in the United States [3]. Older drivers with cognitive impairment due to dementia are more than twice as likely to be crash-involved compared to those without dementia [5,6,7]. Depending on the severity, dementing diseases might be suspected of increasing the risk of crashes because they affect memory, language, visuo-spatial processing, and other higher-order cognitive functions such as judgment and perception that are used to safely drive and control a vehicle [5,6,7,8]
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