[Driving with cognitive impairments: Results of the population-based Digital Dementia Registry Bavaria - digiDEM Bayern]

Abstract

Background: In Germany, the number of drivers aged 65 and over is increasing. However, the risk of physical and cognitive impairments that affect the ability to drive rises with increasing age. Those who give up driving are often confronted with constraints of their autonomy and quality of life. The study aims to identify socio-demographic and health-related determinants of non-driving in people with mild cognitive impairment (MCI) or mild to moderate dementia.

Methods: The data basis is the baseline survey of the multicentre, prospective registry study "Digital Dementia Register Bavaria - digiDEM Bayern". The categorisation of people with MCI and people with mild to moderate dementia is based on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). A diagnosis may exist but is not a requirement. In addition to descriptive analyses, a binary logistic regression was conducted, and average marginal effects (AMEs) were interpreted.

Results: Out of 1,005 participants with a valid driving license, 410 people (40.8%) participate in road traffic as drivers. The probability that people use a car increases with age, peaking at around 70 years and then decreasing. Being female, living in an urban environment, and having a care degree are associated with a lower probability of driving a car, whilst no existing MCI or dementia diagnosis, higher cognitive abilities, and better independence in everyday life (ADLs) are associated with a higher probability.

Conclusion: The decision to continue driving a car depends on several factors, including age, sex, place of residence, and cognitive and physical abilities. Regular assessments of the fitness to drive should take place, and alternative mobility options should be offered to ensure road safety and maintain the quality of life of people with cognitive impairments for as long as possible. The professional and private environment of people with cognitive impairments plays a crucial role in dealing appropriately with these issues.

Keywords: Autonomie; Autonomy; Dementia; Demenz; Driving license; Fahrtauglichkeit; Fitness to drive; Führerschein; Mild Cognitive Impairment (MCI); Mild cognitive impairment (MCI); Mobility; Mobilität.