@article{ref1,
title="Family reports of medically impaired drivers in Missouri: cognitive concerns and licensing outcomes",
journal="Accident analysis and prevention",
year="2015",
author="Meuser, Thomas M. and Carr, David B. and Unger, Elizabeth A. and Ulfarsson, Gudmundur F.",
volume="74",
number="",
pages="17-23",
abstract="This study investigated reasons why older adults (n=689) were reported to the Driver License Bureau, Missouri Department of Revenue, by family members as potentially unfit to drive with an emphasis on cognitive concerns and associated licensing outcomes. A total of 448 drivers were reported to have some cognitive issue; common symptoms included confusion, memory loss, and becoming lost while driving. Diagnostic labels (Alzheimer's disease (AD), cognitive impairment/dementia, brain injury/insult) were listed for 365 cases. A physician evaluation is required for license review. Of those with a diagnostic label, half (51%, n=187) failed to submit this evaluation and almost all were de-licensed immediately. Of those evaluated by a physician, diagnostic agreement between family members and physicians was high for specific conditions (100% for AD, 97% for acute brain injury), and less so for cognitive impairment/dementia (75%). This latter finding suggests that physicians and family members may understand cognitive symptoms differently. Whether cognitively impaired or not, few family reported drivers in this sample (∼2%) retained a valid license. Family members may be in the best position to recognize when medical-functional deficits impact on driving safety, and physicians and driver licensing authorities would do well to take their observations into account with respect to older driver fitness.<p /> <p>Language: en</p>",
language="en",
issn="0001-4575",
doi="10.1016/j.aap.2014.10.002",
url="http://dx.doi.org/10.1016/j.aap.2014.10.002"
}