Elderly drivers with dementia – how do experts and relatives assess their safety risk?

• Published in: European journal of public health 2019-11, Vol.29 (Supplement_4)
• Main Authors: Reime, B, Pilgram, N, Bertsche, T
• Format: Article
• Language: English
• Subjects: Age; Automobiles; Best practice; Cognitive ability; Content analysis; Dementia; Dementia disorders; Demographic change; Driver behavior; Drivers; Driving ability; Experts; Geriatrics; Gerontology; Harm reduction; Motor vehicle drivers; Older people; Patients; Physicians; Police; Public health; Qualitative analysis; Retirement; Risk; Risk assessment; Safety; Traffic accidents & safety; Traffic safety
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckz186.600

Abstract Background Demographic change increases the proportion of car drivers over the age of 70. With increasing age, the likelihood of developing a form of dementia increases. In Germany, about 1.6 million people suffer from dementia. Surveys among dementia patients showed that about two-thirds said they held a valid driving licence and just under half reported still actively driving. We explored whether and to what extent motorists with dementia are putting road safety at risk and how relatives deal with the driving behaviour of their elders. Methods Semi-structured qualitative interviews were conducted with seven experts from the fields of police, gerontology and geriatrics as well as with 16 relatives of patients with different stages of dementia. All interviews were then transcribed. The analyses based on the qualitative content analysis (Mayring 2015) with MAXQDA. Results The experts regarded elderly drivers with dementia as a public health relevant safety risk. Among those elders who are affected by dementia the awareness of the problem often is limited and not rarely they are characterized by an unsafe driving style. Experts from Austria and Switzerland supported the concept of a mandatory dementia assessment for elderly drivers while experts from Germany did not. Relatives reported very similar descriptions of their elderly’s driving characteristics. Furthermore, the cognitive and motor limitations associated with dementia often are not noticed by both patients themselves and their relatives. Conclusions Representative studies are needed to test which measures, such as a mandatory dementia check from retirement age, are likely to improve the safety of older drivers with dementia. Family doctors and GPs should address and educate dementia patients in relation to their risk of accidents. Relatives should receive information material on how to communicate with their elderlys on this topic to maximize safety while avoiding conflict. Key messages The prevalence of elderly drivers with dementia is unknown. Representative studies are needed to test best practice appoaches for harm reduction in drivers with dementia.