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Abstract
Background
There are few studies about driving and dementia in Korea. The purpose of this study is to investigate the real condition of automobile driving in patients with dementia and the characteristics of those who continue to drive after diagnosis of dementia.
Methods
A total of 4,377 patients including 3,792 with Alzheimer's disease and 585 with vascular dementia were recruited from multiple nationwide hospitals. Clinical evaluations and neuropsychological tests were done in them according to the protocol of the Clinical Research Center for Dementia of South Korea study. Caregivers replied which patients drove an automobile, gave up driving, or has never driven. The same evaluations of them were followed after one year.
Results
There were 272 (6.2%) drivers, 321 (7.3%) ex-drivers, and 3,784 (86.5%) non-drivers with dementia. Drivers with dementia were younger and had higher Korean Mini-Mental State Examination (K-MMSE) (21.5±4.3 vs 19.8±5.1 vs 17.4±5.2, p<0.001) and lower Clinical Dementia Rating scale-Sum of Boxes (CDR-SB) scores (4.08±2.15 vs 5.80±3.41 vs 5.83±3.39, p<0.001) compared with ex-drivers and non-drivers with dementia. The drivers and ex-drivers with dementia had higher educational level and a higher proportion of male compared with non-drivers with dementia (77.6% vs 80.1% vs 23.3%, p<0.001). About 54.6% of the drivers with dementia continued to drive at one year after diagnosis of dementia. They had higher K-MMSE (23.2±3.6 vs 20.8±4.5, p=0.003) and lower CDR-SB scores (3.30±1.47 vs 4.40±1.85, p=0.001) at baseline compared with those who quitted driving after baseline.
Figures and Tables
Table 1
Demographic and clinical characteristics of the subjects
*p<0.001 vs non-drivers with dementia; †p<0.001 vs ex-drivers with dementia; ‡p<0.001 vs drivers with dementia.
Values are given as either mean (standard deviation) or number (%).
K-MMSE, Korean Mini-Mental State Examination; CDR-SB, Clinical Dementia Rating Scale-Sum of Boxes; HIS, Hachinski Ischemic Scale; GDS-15, 15-item version of the Geriatric Depression Scale; S-IADL, Seoul Instrumental Activities of Daily Living.
Table 2
Comparison of z-scores of the neuropsychological tests among drivers, ex-drivers, and non-drivers with dementia
Table 3
Comparison of demographic and clinical characteristics between patients who continued driving and those who stopped driving at one year after diagnosis of dementia
Values are given as mean (standard deviation) or number (%).
K-MMSE, Korean Mini-Mental State Examination; CDR-SB, Clinical Dementia Rating Scale-Sum of Boxes; HIS, Hachinski Ischemic Scale; GDS-15, 15-item version of the Geriatric Depression Scale; S-IADL, Seoul Instrumental Activities of Daily Living.
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