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Geriatrics 2018, 3(1), 11; https://doi.org/10.3390/geriatrics3010011

General Cognitive Impairment as a Risk Factor for Motor Vehicle Collision Involvement: A Prospective Population-Based Study

1
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
2
Division of Gerontology, Geriatrics, and Palliative Care, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
3
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA
4
Department of Surgery, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
*
Author to whom correspondence should be addressed.
Received: 29 January 2018 / Revised: 15 February 2018 / Accepted: 28 February 2018 / Published: 6 March 2018
(This article belongs to the Special Issue Aging and Driving)
Full-Text   |   PDF [249 KB, uploaded 6 March 2018]

Abstract

This study examined whether cognitive impairment and decline as assessed by a brief mental status screening test is associated with future crash risk in a cohort of older drivers. A three-year prospective study was conducted in a population-based sample of 2000 licensed drivers, aged 70 years and older. At the baseline visit, cognitive impairment was defined as <24 on the Mini Mental State Exam (MMSE). Decline was defined as those with a one-year change in MMSE scores in the lowest quartile (largest decrease). Motor vehicle collision involvement was obtained from the Alabama Department of Public Safety. Poisson regression was used to calculate crude and adjusted rate ratios (RR). There were 278 crashes during the follow-up period. Rates of crash involvement were higher for those with cognitive impairment (crude RR = 2.33) compared to those without impairment at baseline; adjustment for potential confounders namely age and visual processing speed attenuated this relationship (adjusted RR = 1.26, 95% confidence interval (CI) 0.65–2.44). Drivers who experienced a pronounced decline in estimated MMSE scores in one year were 1.64 (95% CI 1.04–2.57) times more likely to have a future at-fault crash, as compared to those whose scores did not decline. Evaluation of MMSE over time may provide important insight in an older driver’s future risk of at-fault crash involvement. View Full-Text
Keywords: MMSE; crash; older drivers; cognitive decline MMSE; crash; older drivers; cognitive decline
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Huisingh, C.; Owsley, C.; Wadley, V.G.; Levitan, E.B.; Irvin, M.R.; MacLennan, P.; McGwin Jr., G. General Cognitive Impairment as a Risk Factor for Motor Vehicle Collision Involvement: A Prospective Population-Based Study. Geriatrics 2018, 3, 11.

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