Driving cessation in older men with incident dementia

J Am Geriatr Soc. 2000 Aug;48(8):928-30. doi: 10.1111/j.1532-5415.2000.tb06889.x.


Objective: To determine the prevalence and cessation of driving among older men with incident dementia in the Honolulu-Asia Aging Study.

Design: Retrospective cohort data from a community-based study of incident dementia.

Setting: The Honolulu Heart Program and the Honolulu-Asia Aging Study.

Participants: A total of 643 men who were evaluated for the incidence of Alzheimer's disease or other dementia between the fourth and the fifth examination of the Honolulu Heart Program.

Measurements: Driving history, diagnosis of dementia, grip strength, walking speed, standing balance test, interviewer's rating of vision status, and the neurologist's notes on mentions of driving behavior from informal interviews with a caregiver or family informant.

Results: The prevalence of driving declined dramatically with level of cognitive functioning. Among 162 men evaluated and found to have normal cognitive functioning, 78% still drove, compared with 62% of 287 men with poor cognitive functioning but no clinical dementia, 46% of 96 men with a new diagnosis of very mild dementia (Clinical Dementia Rating = 0.5), and 22% of 98 men with a new diagnosis of mild dementia (CDR = 1). Only one of 23 men diagnosed with moderate or more severe staged incident dementia (CDR > 1) was driving. About 10% of the 59 demented persons still driving relied on co-pilots, and only one driver was reported as involved in a crash according to a review of the neurologists' notes.

Conclusions: Incident dementia is a major cause of driving cessation. Based on these data, we estimate that approximately 4% of male drivers aged 75 years and older nationwide (about 175,000 men) have dementia. This number will increase with the projected growth of drivers aged 75 years and older.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Automobile Driving / psychology
  • Automobile Driving / statistics & numerical data*
  • Cognition
  • Dementia / diagnosis
  • Dementia / epidemiology*
  • Dementia / psychology
  • Geriatric Assessment
  • Hand Strength
  • Hawaii / epidemiology
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Mass Screening
  • Prevalence
  • Retrospective Studies
  • Surveys and Questionnaires
  • Walking