Driving Cessation Research Articles

Study protocol of the safe driving program for the prevention of car accidents: A randomized controlled trial protocol.

Driving cessation is strongly associated with adverse health outcomes in older adults. Although numerous studies have focused on driving skill interventions for safe driving, the effects of interventions on car accidents remain unclear. We designed a randomized controlled trial to examine the effects of driving skill training on the prevention of car accidents among community-dwelling older adults using on-road training. A total of 1408 community-dwelling older drivers aged ≥65 years participated in the randomized controlled trial with blinded endpoint assessment. Participants randomized to the intervention group (n = 697) underwent four sessions, with 200 min re-training focused on the problem of driving in the older people. Controls (n = 697) received one classroom education session. On-road driving performance was assessed by certified driving school instructors in a driving school. The primary endpoint is an incident car accident, which will be detected based on the Japanese national car accident report data, after 24 months. This study has the potential to provide the first evidence of the effectiveness of on-road driving skill training regarding the prevention of car accidents. If our trial results show a lower number of car accidents due to driving skill training, this kind of intervention will provide an effective method for maintaining safe driving. These results will be disseminated to the appropriate national transportation agencies to improve or modify safe driving policies and possibly extend the validity of driver's licenses for older adults. UMIN-CTR (identification number: UMIN000034709). Registered 31 October 2018. Geriatr Gerontol Int 2024; 24: 1218-1222.

Impact of driving cessation on health-related quality of life trajectories

BackgroundTrajectories of health-related quality of life (HRQoL) after driving cessation (DC) are thought to decline steeply, but for some, HRQoL may improve after DC. Our objective is to examine trajectories of HRQoL for individuals before and after DC. We hypothesize that for urban drivers, volunteers and those who access alternative transportation participants’ health may remain unchanged or improve.MethodsThis study uses data from the AAA Longitudinal Research on Aging Drivers (LongROAD) study, a prospective cohort of 2,990 older drivers (ages 65–79 at enrollment). The LongROAD study is a five-year multisite study and data collection ended October 31, 2022. Participants were recruited using a convenience sample from the health centers roster. The number of participants approached were 40,806 with 7.3% enrolling in the study. Sixty-one participants stopped driving permanently by year five and had data before and after DC. The PROMIS®-29 Adult Profile was utilized and includes: 1) Depression, 2) Anxiety, 3) Ability to Participate in Social Roles and Activities, 4) Physical Function, 5) Fatigue, 6) Pain Interference, 7) Sleep Disturbance, and 8) Numeric Pain Rating Scale.Adjusted (age, education and gender) individual growth models with 2989 participants with up to six observations from baseline to year 5 in the models (ranging from n = 15,041 to 15,300) were utilized.ResultsAbility to participate in social roles and activities after DC improved overall. For those who volunteered, social roles and activities declined not supporting our hypothesis. For those who accessed alternative transportation, fatigue had an initial large increase immediately following DC thus not supporting our hypothesis. Urban residents had worse function and more symptoms after DC compared to rural residents (not supporting our hypothesis) except for social roles and activities that declined steeply (supporting our hypothesis).ConclusionsEducating older adults that utilizing alternative transportation may cause initial fatigue after DC is recommended. Accessing alternative transportation to maintain social roles and activities is paramount for rural older adults after DC especially for older adults who like to volunteer.

Development and Initial Validation of the Transportation Support Scale.

Driving cessation affects older drivers and, possibly, also care partners (most of whom tend to be women). Although tools exist to assess the effects on family and friends of providing informal care to someone who needs assistance, no tool is available to clinicians that specifically focuses on the effects of driving cessation. To develop the Transportation Support Scale (TSS) to measure care partners' responses-both negative and positive-to driving cessation and assuming transportation responsibilities. We developed a list of 98 items to capture the impact on care partners of providing transportation to older adults who have stopped driving. In Phase 1, we pretested the items qualitatively with a small sample of care partners. In Phase 2, we reduced the number of items and examined several psychometric properties of the TSS with a larger sample. Community. Two convenience samples of care partners who provide transportation (Phase 1, n = 11; Phase 2, n = 66). The initial pool of items was reduced from 98 to 22. The final TSS has an internal consistency of .88 (Cronbach's α). Thirty-five percent of care partners' scores fell above the middle possible score; these care partners were likely experiencing a high negative impact related to providing transportation after driving cessation. The TSS demonstrated adequate preliminary psychometric properties. We need additional research to further evaluate the psychometric properties of the TSS (e.g., test-retest reliability). A fully validated TSS may be useful to clinicians and researchers. What This Article Adds: The TSS has the potential to help clarify the perspective of care partners as well as inform the development and evaluation of services for care partners who are providing transportation to former drivers.

Still in first gear: Exploration of barriers for implementing driving cessation support.

Driving cessation is a major life transition; lack of support in this process may lead to deleterious outcomes in terms of physical, mental and social well-being. Despite approaches to driving cessation being developed, their integration into ongoing geriatric clinical practice has been slow. Health-care providers were surveyed about their impressions of the barriers and facilitators to implementing a driving cessation intervention as part of regular clinical services. Methods of funding the intervention were queried. Surveys were sent via professional listserves and a snowballing strategy employed. Twenty-nine completed surveys were analysed by content analysis. Participants identified that an understanding of driving cessation and optimal driving cessation supports was required. They identified four key approaches to support the implementation of driving cessation support: the need to consider complexity and emotional support needs in clinical contexts; knowing and showing the outcomes by clearly communicating the benefits and values to different stakeholders; managing systemic barriers included workforce issues, funding models and efforts required for initiating and sustaining an intervention; and not doing it alone, but instead developing processes supports to collaboratively provide access to programs. The current study reveals a recognition of unmet needs of older persons and families regarding driving cessation as well as signalling service delivery, costing and workforce needs which act as barriers.

Driving following a diagnosis of dementia: Exploring the views and experiences of people with dementia-A UK survey.

Driving cessation can be one of the adjustments made following a diagnosis of dementia. Little is known about the views and opinions of people living with dementia about this. The study aimed to gather a broad idea of the expectations, impacts and the process of driving cessation from the perspective of those living with dementia. 138 people with dementia and 91 relatives/friends (on behalf of an individual with dementia) took part in an online questionnaire. People living with dementia reported stopping driving following diagnosis can have negative psychological impacts particularly in relation to; feelings of isolation, depression, loss of freedom and feeling life isn't worth living. Age, gender and choice in the driving cessation process were related to the degree of negative experiences. The difficulties reported by people with dementia suggest a need to provide more structured post diagnostic support to aid decision making of driving continuation or cessation; with the view to reducing associated distress and enabling people with dementia to continue to live a meaningful life.

COMMUNITY MOBILITY PATTERNS OF OLDER ADULTS DURING THE COVID-19 PANDEMIC

Abstract The COVID-19 pandemic has had appreciative impacts on the lives of older adults. At various times during the pandemic, Canadian provinces put in place public health measures to prevent the spread of the virus, including closures of non-essential businesses and services. The Candrive Driving Cessation sub-study is a 12-year, mixed methods, longitudinal study. During the COVID-19 pandemic, participants from four sites (n=124, mean age=85.5 years) were asked to report how their community mobility patterns during the pandemic compared with before the pandemic. They also completed the COVID-19 Anxiety Syndrome Scale and the Assessment of Readiness for Mobility Transition (ARMT) tool. The results indicated that during the pandemic, participants were less likely to drive (χ2=7.11, p=.004) or ride a public bus (χ2=20.05, p<.001) when leaving their home. During the pandemic, they reported fewer trips to the supermarket (χ2=99.00, p<.001) and fewer visits with family (χ2=68.00, p=.001). We observed a statistically significant relationship between COVID-19 Anxiety Syndrome Scale scores and ARMT (Anticipatory Anxiety subscale; r= .810, p<.001), such that higher COVID-19-related anxiety was associated with greater anxiety related to anticipating changes in mobility. These results emphasize the impacts of the COVID-19 pandemic on the mobility patterns of older adults. Promoting community mobility for older adults alongside preventative public health measures is essential.

Understanding the relationship between eye disease and driving in very old Australian women: a longitudinal thematic evaluation

BackgroundOver recent decades an increasing number of adults will retain their driver’s licenses well into their later years. The aim of this study was to understand and explore the experience of driving and driving cessation in very old Australian women with self-reported eye disease.MethodsAn interpretative qualitative study. Participants were from the Australian Longitudinal Study on Women’s Health (cohort born in 1921–26), a sample broadly representative of similarly aged Australian women. Responses to open-ended questions were analysed using an inductive thematic approach, employing a process of constant comparison.ResultsQualitative data were from 216 older women with eye disease who made 2199 comments about driving, aged between 70 and 90 years depending on the timing of their comments. Themes included: (1) Access to treatment for eye disease promotes driving independence and quality of life; (2) Driving with restrictions for eye disease enables community engagement and (3) Driving cessation due to poor vision leads to significant lifestyle changes.ConclusionsKey findings highlighted driving cessation, or reduction, is often attributed to deterioration in vision. The consequence is dependence on others for transport, typically children and friends. Access to successful treatment for eye disease allowed older women to continue driving. We posit that occupational therapists can play an essential role in promote driving confidence and ability as women age.Trial registration: Not applicable.

Clinical Factors Predicting Voluntary Driving Cessation among Patients with Parkinson's Disease.

Factors that influence the decision of voluntary driving cessation in patients living with Parkinson's disease (PD) are still unclear. We aimed to reveal the factors affecting the decision of voluntary driving cessation in patients with PD. This hospital-based cross-sectional study recruited consecutive outpatients with PD. Data on sociodemographic and clinical characteristics and medication use were collected from the patients using semistructured interviews. Cognitive function was evaluated using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). We excluded patients with dementia or motor impairment (Hoehn − Yahr stage > 3). We divided the patients into two groups, with and without voluntary driving cessation (D: driver; RD: retired driver), and conducted investigations using multivariate logistic regression analyses. Of the 40 patients, 8 (20.0%) voluntarily retired from driving. Patients who decided on driving cessation had a higher prevalence of freezing of gait (FOG) (D vs. RD, 25.0% vs. 87.5%; P = 0.001) and tended to have lower scores for attention in the MoCA-J (D vs. RD, 5.0 ± 1.2 vs. 4.1 ± 1.4; P = 0.086). Multivariable analysis showed that FOG was independently associated with driving cessation (odds ratio: 14.46, 95% confidence interval: 1.91–303.74). FOG was associated with voluntary driving cessation in patients with PD without dementia or severe motor impairment. Physicians should consider providing extensive social support to maintain patients' mobility and independence, especially if the patients have these clinical factors.

Factors Affecting Driving Cessation of Older Adults and Their Satisfaction with Mobility Options

Out-of-home mobility has been identified as essential for older adults to access activities in their community that keep them healthy and well. As individuals grow older, they are more likely to experience medical conditions and other health-related changes that can affect their ability to drive. Balancing older peoples’ continued mobility against their own and others’ safety has been always a challenge. Therefore, it is important to understand elderly people’s everyday mobility issues and challenges/factors associated with driving cessation. This paper aims to identify and quantify factors contributing to older adults’ satisfaction with their everyday mobility using ordered probit (OP) modeling. Its underlying objective is to provide better understanding of factors that may influence older adults to stop driving. The data used in the analysis was obtained through an online survey of 1,000 Canadians aged 65+. The results of the OP model indicate that several factors affect older adults’ satisfaction with their everyday mobility including driving a car to reach destinations, ability to drive alone (without help from others), experiencing difficulties/challenges with driving, having a physical health issue restricting the ability to walk, fear of falling while walking, and inability to visit local places as often as desirable. The findings also suggest that factors influencing older drivers’ decisions to retire from driving (for those already retired from driving) are different from those perceived by people still driving. The study’s results provide insights about policies and countermeasures that can be implemented to improve the safety and mobility of the aging population.

Changes in Health-Related Quality of Life After Driving Cessation in Older Adults

Changes in Health-Related Quality of Life After Driving Cessation in Older Adults

A Data Science Approach to Estimating the Frequency of Driving Cessation Associated Suicide in the US: Evidence From the National Violent Death Reporting System.

Driving cessation is a common transition experienced by aging adults that confers both a symbolic and literal loss of independence due to the central role of automobiles for mobility in the US. Prior research has shown that driving cessation has negative implications for mental health, social participation, and access to healthcare. Given these sequelae of driving cessation and prior work showing that late-life transitions related to independence (e.g., transitioning into residential care) are associated with suicide, we sought to estimate the frequency of driving cessation associated suicide. Data include suicide (n = 59,080) and undetermined (n = 6,862) deaths aged ≥55 from the National Violent Death Reporting System (NVDRS, 2003–2017). Each case in the NVDRS has both quantitative data (e.g., demographic characteristics) and qualitative text narratives, derived from coroner/medical examiner reports, which describe the most salient circumstances and features of each death. To identify cases associated with driving cessation, we employed a supervised random forest algorithm to develop a Natural Language Processing (NLP) classifier. Identified driving cessation associated cases were then categorized and characterized using descriptive statistics and qualitative content analysis. From 2003 to 2017, there were an estimated 305 cases of suicide/undetermined deaths associated with driving cessation in the NVDRS, representing 0.04% of all cases. Cases associated with driving cessation were older, more likely to be male, more likely to have a physical health problem, more likely to have experienced a recent crisis, and more likely to have lived in a rural county than other decedents. Qualitative analysis identified functional impairment, alcohol-related driving limitations, loss of employment, and recent car accidents as common themes among cases associated with driving cessation. This analysis illustrates the utility of NLP in identifying novel correlates of suicide in later life. Although driving cessation associated suicide is a rare outcome, further research is warranted on understanding the conditions under which driving cessation is associated with suicidal behavior, and how to support the well-being of aging adults during these types of major life transitions.

The Predictors of Driving Cessation among Older Drivers in Korea.

Background: As the elderly population and the number of older drivers grow, public safety concerns about traffic accidents involving older drivers are increasing. Approaches to reduce traffic accidents involving older drivers without limiting their mobility are needed. This study aimed to investigate the driving cessation (DC) rate among older Korean adults and predictors of DC based on the comprehensive mobility framework. Method: In this cross-sectional study, data from 2970 to 10,062 older adults over 65 years old from the 2017 National Survey of Elderly People were analyzed in April 2020. Multivariate logistic regression analyses were conducted to identify the predictors of DC. Results: Residential area, an environmental factor, was a strong predictor of DC (Odds Ratio (OR) 2.21, 95% Confidential Interval (CI) 1.86–2.62). Older drivers living in an area with a metro system were 2.21 more likely to stop driving than those living in an area without a metro system. Other demographic, financial, psychosocial, physical, and cognitive variables also predicted DC. Conclusion: Environmental factors were strong predictors of older adults’ DC. Therefore, political and environmental support, such as the provision of accessible public transportation, is essential to increase the DC rate among older adults to increase public safety without decreasing their mobility.

Effects of an Unexpected and Expected Event on Older Adults' Autonomic Arousal and Eye Fixations During Autonomous Driving.

Driving cessation for some older adults can exacerbate physical, cognitive, and mental health challenges due to loss of independence and social isolation. Fully autonomous vehicles may offer an alternative transport solution, increasing social contact and encouraging independence. However, there are gaps in understanding the impact of older adults’ passive role on safe human–vehicle interaction, and on their well-being. 37 older adults (mean age ± SD = 68.35 ± 8.49 years) participated in an experiment where they experienced fully autonomous journeys consisting of a distinct stop (an unexpected event versus an expected event). The autonomous behavior of the vehicle was achieved using the Wizard of Oz approach. Subjective ratings of trust and reliability, and driver state monitoring including visual attention strategies (fixation duration and count) and physiological arousal (skin conductance and heart rate), were captured during the journeys. Results revealed that subjective trust and reliability ratings were high after journeys for both types of events. During an unexpected stop, overt visual attention was allocated toward the event, whereas during an expected stop, visual attention was directed toward the human–machine interface (HMI) and distributed across the central and peripheral driving environment. Elevated skin conductance level reflecting increased arousal persisted only after the unexpected event. These results suggest that safety-critical events occurring during passive fully automated driving may narrow visual attention and elevate arousal mechanisms. To improve in-vehicle user experience for older adults, a driver state monitoring system could examine such psychophysiological indices to evaluate functional state and well-being. This information could then be used to make informed decisions on vehicle behavior and offer reassurance during elevated arousal during unexpected events.

The Risk of Functional Limitations After Driving Cessation Among Older Japanese Adults: The JAGES Cohort Study.

BackgroundPopulation ageing and stringent licensing policies will increase the number of older drivers who stop driving. Adverse health outcomes owing to driving cessation and their prevention are emerging concerns. Therefore, we longitudinally examined the impact of driving cessation and alternative transportation use after cessation on the risk of functional limitations in a cohort of community-dwelling people (65 years and older) in Japan.MethodsUsing cohort data of those who drove as of 2006/07, we compared the risk of functional limitations between 2,704 current drivers and 140 former drivers (who stopped driving by 2010). Of the former drivers, 77 did not use public transportation or bicycles after driving cessation (thus losing independent mobility). We calculated the hazard ratios (HRs) for the incidence of functional limitations with 95% confidence intervals (CIs) based on the Cox proportional hazards model with the covariates influencing the functional limitations.ResultsFrom 2010 through 2016, 645 people had functional limitations, which included 38, 82, and 119 per 1,000 person-years among current drivers, former drivers who used public transportation or bicycles, and former drivers who were only driven by others, respectively (HR 1.69; 95% CI, 1.15–2.49 and HR 2.16; 95% CI, 1.51–3.10, relative to current drivers).ConclusionDriving cessation is associated with an increased risk of functional limitations among older adults, but this risk might be alleviated if they are able to maintain independent mobility using public transportation or bicycles after driving cessation.

To drive or not to drive: Driving cessation amongst older adults in rural and small towns in Canada

Driving cessation, often due to health-related changes, can be a particularly challenging and troublesome transition in older adulthood that can lead to social isolation. While policy makers have long recognized the potential impact of an aging population on Canada's health care and national pension plans, the transportation needs of older adults have received relatively less attention. For older adults residing in small towns and rural areas who rely, more often than not, on the personal automobile there is usually limited or no access to public transportation. For policy makers to respond effectively to the transportation needs of an aging population, particularly those living in rural areas, the first step is to understand the travel behaviours of older adults living in such areas, particularly as they approach the transition when they will cease to drive. This paper reports on qualitative research exploring the driving-related challenges and needs faced by older adults in small towns and rural areas near Hamilton, Ontario, Canada. Results revealed four major themes: lack of transportation options in rural areas, changes in driving behaviours, the lack of planning for driving cessation, and the social isolation that comes from the loss (or potential loss) of one's driver's license.

Barriers and facilitators to social participation after driving cessation among older adults: A cohort study.

Driving cessation is a challenging transition for older drivers. It is indeed often associated with reduced mobility, loss of autonomy and poor quality of life, as in individuals with acquired disabilities. We examined factors that inhibit or facilitate out-of-home occupations after driving cessation (shopping, visiting/helping friends/family, leisure, and associative activities) in older adults, with particular focus on the role of anticipation. This longitudinal study was conducted with the SAFE MOVE cohort (n=1014 drivers aged≥70 years). Socio-demographic, health, cognitive, mobility and out-of-home occupations data were collected at home at baseline and by a postal questionnaire at 2-year follow-up. In total, 48 (5%) participants stopped driving between baseline and follow-up, at a mean age of 81.8 years; 71% of drivers who stopped reported that driving cessation affected their out-of-home occupations. Participation in social occupations started to decline before driving cessation. Retired drivers were older, had poorer health, poorer cognitive abilities, drove less at baseline but used more public transportation than active drivers. As compared with participants who did not consider driving cessation at baseline, those who did were more likely to expect a better quality of life in the event of driving cessation and to use public transportation at baseline and follow-up despite their older age and poorer health. Some factors associated with reduced social participation and driving cessation are inevitable, such as health status. However, other factors may facilitate maintenance of social participation, including anticipation of driving cessation and mobility habits. Our findings highlight the need for appropriate interventions that are widely available to older drivers before driving cessation occurs and for public policy actions facilitating alternative transport systems.

Driving cessation and social participation in late life: A systematic review

ABSTRACT Driving cessation is a major life transition in late life and can affect the quality of social life in older adults. The present study aims to systematically review the literature on how driving cessation affects social participation among older adults in the US. The study selection followed the PRISMA. Extant literature published from 1990 to 2019 that examined driving cessation and social participation or social engagement among older adults in the US was searched using eight search engines: PsycINFO, CINAHL, SocIndex, AgeLine, MedLine, Scopus, Transportation Research Board Publication Index, and Cochrane Library. Quantitative studies that met the inclusion criteria were reviewed. The assessment of methodological quality was also conducted for included studies. In total, seven studies met the inclusion criteria. Six of the included studies found significant relationships between driving cessation and at least one domain of social participation, such as volunteering, employment, leisure-time activities, and the frequency of contacts. In addition, the measures of social participation were inconsistent across studies, which might explain the mixed findings. There is a need to assist older adults in successfully transitioning to driving cessation and maintaining the social participation.

DRIVING CESSATION IS ASSOCIATED WITH POORER MENTAL HEALTH

The Canadian Longitudinal Study on Aging (CLSA) is a longitudinal health study that will follow individuals aged 45 to 85 for 20 years. At baseline, participants completed measures related to driving status and mental health outcomes (e.g., Center for Epidemiologic Studies Depression Scale; CES-D). In this study we examined the associations between driving status and mental health outcomes. In the baseline sample, 1,415 participants reported being former drivers and 44,694 reported being current drivers. A greater proportion of former drivers were female, older, and urban-dwelling. Compared to current drivers, former drivers had lower levels of social support, poorer self-rated physical health, and less community participation. After controlling for these covariates as well as age and sex, former drivers had greater odds than current drivers of being classified as depressed (OR=2.48, 95% CI=2.21-2.79), and of reporting psychological distress (OR=2.22, 95% CI=1.87-2.62). Using data from former drivers only, we also examined associations between variables that contributed to driving cessation and depression symptoms. Former drivers had greater odds of being depressed if they reported feeling nervous or intimidated behind the wheel (OR=1.77, 95% CI= 1.11 - 2.80), or if they experienced difficulties with the licensing process (OR=1.62, 95% CI=1.07 - 2.54), before they stopped driving. As a next step we will search for factors that may modify the relationship between driving status and mental health. The identification of factors that modify the impact of driving cessation on mental health is critical to the development of interventions that will support smoother transitions to non-driving.

Effects of Older Adult Driving Resumption on All-Cause Mortality.

Driving cessation is associated with adverse social and health outcomes including increased mortality risk. Some former drivers resume driving. Do resumed drivers have a different mortality risk compared to former drivers or continued drivers? We analyzed National Health and Aging Trends Study (2011-2015) data of community-dwelling self-responding ever drivers (n = 6,189) with weighted stratified life tables and discrete time logistic regression models to characterize mortality risk by driving status (continued, resumed, former), adjusting for relevant sociodemographic and health variables. Overall, 14% (n = 844) of participants died and 52% (n = 3,209) completed Round 5. Former drivers had the highest mortality (25%), followed by resumed (9%) and continued (6%) drivers. Former drivers had 2.4 times the adjusted odds of mortality compared with resumed drivers (adjusted odds ratio [aOR] = 2.41; 95% confidence interval [CI] = 1.51, 3.83), with no difference between continued and resumed drivers (aOR = 1.22; 95% CI = 0.74, 1.99). Those who resumed driving had better survival than those who did not. Practice implications include driver rehabilitation and retraining to safely promote and prolong driving.

PERSPECTIVES FROM THE FIELD: DESIGNING THE DRIVING CESSATION IN DEMENTIA INTERVENTION TOOLKIT (DCD-IT)

Introduction Decision-making about driving cessation and transitioning to non-driving is a challenging and complex issue faced by drivers diagnosed with dementia and their families. Driving cessation is associated with adverse psychosocial and health-related impacts for persons with dementia including a reduction in quality of life. To address the gap in evidence-based interventions that support individuals in the driving cessation process, we developed the Driving Cessation in Dementia Intervention Toolkit (DCD-IT). Our objective in this study was to further develop and refine the DCD-IT (content, design and mode of delivery) to facilitate its effective implementation in settings that support older adults with dementia. Methods Representatives (n=15) from Alzheimer Society organizations in British Columbia, Manitoba, Ontario and Nova Scotia reviewed the DCD-IT and provided feedback via a webinar, questionnaire and in-depth interviews. Data analysis techniques included thematic coding and inductive analysis. Results Participants emphasized the lack of accessible and trusted driving cessation resources specific to meeting the needs of persons with dementia (PWD) and their family caregivers. They identified gaps and corresponding areas of focus to inform the continued development and design of the DCD-IT, which included: materials directed separately to PWD encompassing appropriate content, language and design; resources geared to helping healthcare providers engage in discussions with PWD and family caregivers; information for PWD, family caregivers and healthcare providers about region-specific driving regulations and alternative transportation options. Conclusions Obtaining the perspectives of Alzheimer Society representatives have informed improvements to the content and design of the DCD-IT. Next steps include evaluating the implementation process of the intervention framework and toolkit in Alzheimer Society chapters in community settings in Ontario with the aim of informing widespread implementation and adaption across Canada. This research was funded by Canadian Institute of Health Research/Canadian Consortium on Neurodegeneration in Aging.