Clinical Interventions in Aging (Feb 2020)
Driver Self-Regulation Practices in Older Drivers with and Without Mild Cognitive Impairment
Abstract
Ying Ru Feng,1 Lynn Meuleners,1 Mark Stevenson,2,3 Jane Heyworth,1 Kevin Murray,1 Sean Maher4 1School of Population and Global Health, The University of Western Australia, Perth, WA, Australia; 2Transport, Health and Urban Design, Melbourne School of Design, University of Melbourne, Melbourne, VIC, Australia; 3Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; 4Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Perth, WA, AustraliaCorrespondence: Lynn MeulenersSchool of Population and Global Health, The University of Western Australia (M431), 35 Stirling Hwy, Crawley, Perth, WA 6009, AustraliaTel +61 8 6488 7375Email [email protected]: To assess the impact of cognitive, socio-demographic and driving-related characteristics on self-regulation practices in older drivers with mild cognitive impairment (MCI) (determined by the Telephone Cognitive Screen (T-CogS) score), compared with drivers with no cognitive impairment.Design, Setting, Participants: A cross-sectional study collected information from 362 drivers with MCI and 611 drivers with no cognitive impairment, who were aged 65+ years, and were living in Western Australia between November 2018 and February 2019.Measurements: Self-reported self-regulation driving practices.Results: The majority of drivers with MCI (62.4%) and those with no cognitive impairment (57.1%) reported self-regulating their driving in at least one situation, in the past three months. The most common situations that both groups of drivers self-regulated in were “driving at night in the rain”, “parallel parking”, and “driving when raining”. Drivers with MCI were only significantly more likely to self-regulate when “making turns across oncoming traffic” and “driving at night”. They also had 39% greater odds of self-regulating in at least one driving situation, compared with drivers with no cognitive impairment (OR: 1.39, 95% CI=1.04– 1.85, p=0.02). Females also had 2.3 times greater odds of self-regulating (OR=2.34, 95% CI=1.76– 3.12, p< 0.001). Drivers aged 75+ years had 1.6 times greater odds of self-regulating, compared with drivers aged 65– 69 years (OR=1.58, 95% CI=1.12– 2.23, p=0.01).Conclusion: Older drivers with MCI were more likely to self-regulate their driving, compared to drivers with no cognitive impairment, particularly in complex driving situations. This suggests that some drivers with MCI may be able to recognize their cognitive limitations and adjust their driving accordingly. However, several drivers with MCI, particularly males, did not self-regulate their driving. This highlights the importance of advising patients about the impact of MCI on driving ability, suitable self-regulation strategies, as well as monitoring their driving ability.Keywords: driving, aging, self-regulation, older drivers, mild cognitive impairment
