CMAJ • January 30, 2007; 176 (3). doi:10.1503/cmaj.1060208.
© 2007 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by O'Neill, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by O'Neill, D.
Related Collections
Right arrow Other ethics
Right arrow Patient-caregiver communication
Right arrow Psychogeriatrics

Letters

Driving and dementia

Desmond O'Neill

Associate Professor, Department of Medical Gerontology, Trinity College, Dublin, Ireland

As a result of the work of Nathan Herrmann and colleagues1 we now have an improved understanding of the factors involved in driving cessation among people with dementia. Of particular interest was the finding that living in a jurisdiction with mandatory reporting did not significantly increase the risk of driving cessation. This leads one to question the utility of mandatory reporting, which may deter patients with dementia from relaying concerns about deterioration in their level of functioning to their physician.

Perhaps we are missing a more important issue associated with driving cessation if we focus unduly on safety rather than on mobility. Driving cessation is associated with significant difficulty in accessing services2 and is an independent risk factor for entry to a nursing home.3 Easy access to transportation is a key factor in maintaining the health and independence of older people and promotes social inclusion.4,5

Concern has been expressed that older people are discriminated against in public discussions about driving and health because of the emphasis on safety at the expense of a balanced perspective of the importance of both mobility and safety to health and social inclusion.6 As physicians, we need to be mindful of the enabling aspects of driving assessment (e.g., by an appropriate focus on arthritis, vision and medication review7), as well as the need to actively support other forms of facilitated transport (people who stop driving are usually not able to manage the rigours of public transportation).8 It is also important that any public health discourse support outdoor mobility and transportation for our patients.

REFERENCES

  1. Herrmann N, Rapoport MJ, Sambrook R, et al; Canadian Outcomes Study in Dementia (COSID) Investigators. Predictors of driving cessation in mild-to-moderate dementia. CMAJ 2006;175:591-5. [Abstract/Free Full Text]
  2. Taylor BD, Tripodes S. The effects of driving cessation on the elderly with dementia and their caregivers. Accid Anal Prev 2001;33:519-28.[CrossRef][Medline]
  3. Freeman EE, Gange SJ, Munoz B, et al. Driving status and risk of entry into long-term care in older adults.Am J Public Health 2006;96:1254-9. [Abstract/Free Full Text]
  4. Final report of the White House Conference on Aging; 2005 Dec 11-14; Washington (DC). Washington (DC): US Department of Health and Social Services; 2006. Available: www.whcoa.gov (accessed 2006 Dec 5).
  5. Organisation for Economic Co-operation and Development. Ageing and transport: mobility needs and safety issues. Paris: The Organisation; 2001.
  6. Martin A, Balding L, O'Neill D. Are the media running elderly drivers off the road? BMJ 2005;330:368. [Free Full Text]
  7. O'Neill D, Dobbs B. Age-related disease, mobility and driving. In: Transportation in an aging society: a decade of experience. Transportation Research Board Conference Proceedings 27. Washington (DC): Transportation Research Board; 2004. p. 56-66.
  8. Freund K. Independent transportation network: alternative transportation for the elderly. Transportation News 2000;206:3-12.




This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by O'Neill, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by O'Neill, D.
Related Collections
Right arrow Other ethics
Right arrow Patient-caregiver communication
Right arrow Psychogeriatrics