Driving predictors in a cohort of cognitively impaired Mexican American and non-Hispanic White individuals.


Journal

Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062

Informations de publication

Date de publication:
11 2023
Historique:
revised: 09 06 2023
received: 01 05 2023
accepted: 13 06 2023
medline: 16 11 2023
pubmed: 29 6 2023
entrez: 29 6 2023
Statut: ppublish

Résumé

Individuals with Alzheimer's disease and Alzheimer's disease-related dementias may lose the ability to drive safely as their disease progresses. Little is known about driving prevalence in older Latinx and non-Hispanic White (NHW) individuals. We investigated the prevalence of driving status among individuals with cognitive impairment in a population-based cohort. This was a cross-sectional analysis of the cohort BASIC-Cognitive study in a community of Mexican American (MA) and NHW individuals in South Texas. Participants scored ≤25 on the Montreal Cognitive Assessment (MoCA), indicating a likelihood of cognitive impairment. Current driving status was assessed by the Harmonized Cognitive Assessment Protocol informant interview. Logistic regression was used to assess driving versus non-driving adjusted for pre-specified covariates. Chi-square and Mann-Whitney U tests were used to compare NHW and MA differences in driving outcomes from the American Academy of Neurology (AAN) questions for evaluating driving risk in dementia. There were 635 participants, 77.0 mean age, 62.4% women, and 17.3 mean MoCA. Of these, 360 (61.4%) were current drivers with 250 of 411 (60.8%) MA participants driving, and 121 of 190 (63.70%) NHW participants driving (p = 0.50). In fully adjusted models age, sex, cognitive impairment, language preference, and Activities of Daily Living scores were significant predictors for the likelihood of driving (p < 0.0001). Severity of cognitive impairment was inversely associated with odds of driving, but this relationship was not found in those preferring Spanish language for interviews. Around one-third of all caregivers had concerns about their care-recipient driving. There were no significant differences in MA and NHW driving habits and outcomes from the AAN questionnaire. The majority of participants with cognitive impairment were currently driving. This is a cause for concern for many caregivers. There were no significant ethnic driving differences. Associations with current driving in cognitively impaired persons require further research.

Sections du résumé

BACKGROUND
Individuals with Alzheimer's disease and Alzheimer's disease-related dementias may lose the ability to drive safely as their disease progresses. Little is known about driving prevalence in older Latinx and non-Hispanic White (NHW) individuals. We investigated the prevalence of driving status among individuals with cognitive impairment in a population-based cohort.
METHODS
This was a cross-sectional analysis of the cohort BASIC-Cognitive study in a community of Mexican American (MA) and NHW individuals in South Texas. Participants scored ≤25 on the Montreal Cognitive Assessment (MoCA), indicating a likelihood of cognitive impairment. Current driving status was assessed by the Harmonized Cognitive Assessment Protocol informant interview. Logistic regression was used to assess driving versus non-driving adjusted for pre-specified covariates. Chi-square and Mann-Whitney U tests were used to compare NHW and MA differences in driving outcomes from the American Academy of Neurology (AAN) questions for evaluating driving risk in dementia.
RESULTS
There were 635 participants, 77.0 mean age, 62.4% women, and 17.3 mean MoCA. Of these, 360 (61.4%) were current drivers with 250 of 411 (60.8%) MA participants driving, and 121 of 190 (63.70%) NHW participants driving (p = 0.50). In fully adjusted models age, sex, cognitive impairment, language preference, and Activities of Daily Living scores were significant predictors for the likelihood of driving (p < 0.0001). Severity of cognitive impairment was inversely associated with odds of driving, but this relationship was not found in those preferring Spanish language for interviews. Around one-third of all caregivers had concerns about their care-recipient driving. There were no significant differences in MA and NHW driving habits and outcomes from the AAN questionnaire.
CONCLUSIONS
The majority of participants with cognitive impairment were currently driving. This is a cause for concern for many caregivers. There were no significant ethnic driving differences. Associations with current driving in cognitively impaired persons require further research.

Identifiants

pubmed: 37382492
doi: 10.1111/jgs.18493
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

3520-3529

Subventions

Organisme : NIA NIH HHS
ID : R01 AG069148
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS100687
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG024824
Pays : United States

Informations de copyright

© 2023 The American Geriatrics Society.

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Auteurs

Madelyn Malvitz (M)

Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Darin B Zahuranec (DB)

Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Wen Chang (W)

University of Michigan Institute of Social Research, Ann Arbor, Michigan, USA.

Steven G Heeringa (SG)

University of Michigan Institute of Social Research, Ann Arbor, Michigan, USA.

Emily M Briceño (EM)

Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Roshanak Mehdipanah (R)

Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.

Xavier F Gonzales (XF)

Department of Life Sciences, Texas A&M Corpus Christi, Corpus Christi, Texas, USA.

Deborah A Levine (DA)

Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Kenneth M Langa (KM)

University of Michigan Institute of Social Research, Ann Arbor, Michigan, USA.
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, USA.

Nelda Garcia (N)

Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Lewis B Morgenstern (LB)

Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
University of Michigan School of Public Health Center for Social Epidemiology and Population Health, Ann Arbor, Michigan, USA.

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