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Psychometrics of the AAN Caregiver Driving Safety Questionnaire and contributors to caregiver concern about driving safety in older adults

Published online by Cambridge University Press:  02 October 2017

Janessa O. Carvalho ,
Beth Springate ,
Rachel A. Bernier  and
Jennifer Davis
Janessa O. Carvalho*
Affiliation:
Department of Psychology, Bridgewater State University, Bridgewater, MA
Beth Springate
Affiliation:
Department of Psychiatry, University of Connecticut Health Center, Farmington, CT
Rachel A. Bernier
Affiliation:
Department of Psychology, Pennsylvania State University, State College, PA
Jennifer Davis
Affiliation:
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
*
Correspondence should be addressed to: Janessa O. Carvalho, PhD, Department of Psychology, Bridgewater State University, 131 Summer Street, Bridgewater, MA 02325, USA. Email: Janessa.Carvalho@bridgew.edu. Phone: 508-531-1875.
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Abstract

Background:

The American Academy of Neurology (AAN) updated their practice parameters in the evaluation of driving risk in dementia and developed a Caregiver Driving Safety Questionnaire, detailed in their original manuscript (Iverson Gronseth, Reger, Classen, Dubinsky, & Rizzo, 2010). They described four factors associated with decreased driving ability in dementia patients: history of crashes or citations, informant-reported concerns, reduced mileage, and aggressive driving.

Method:

An informant-reported AAN Caregiver Driving Safety Questionnaire was designed with these elements, and the current study was the first to explore the factor structure of this questionnaire. Additionally, we examined associations between these factors and cognitive and behavioral measures in patients with mild cognitive impairment or early Alzheimer's disease and their informants.

Results:

Exploratory factor analysis revealed a four-component structure, consistent with the theory behind the AAN scale composition. These four factor scores also were significantly associated with performance on cognitive screening instruments and informant reported behavioral dysfunction. Regressions revealed that behavioral dysfunction predicted caregiver concerns about driving safety beyond objective patient cognitive dysfunction.

Conclusions:

In this first known quantitative exploration of the scale, our results support continued use of this scale in office driving safety assessments. Additionally, patient behavioral changes predicted caregiver concerns about driving safety over and above cognitive status, which suggests that caregivers may benefit from psychoeducation about cognitive factors that may negatively impact driving safety.

Keywords

drivingdementianeuropsychology
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 3: Issue Theme: Psychosocial Interventions for Dementia , March 2018 , pp. 355 - 364
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Albert, M. S. et al. (2011). The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the national institute on aging-alzheimer's association workgroups on diagnostic guidelines for alzheimer's disease. Alzheimer's & Dementia, 7, 270–279.Google Scholar
Baldock, M. R. J., Mathias, J. L., McLean, A. J. and Berndt, A. (2006). Self-regulation of driving and its relationship to driving ability among older adults. Accident Analysis & Prevention, 38, 1038–1045.Google Scholar
Benton, A. L., Varney, N. R. and Hamsher, K. D. (1978). Visuospatial judgment. A clinical test. Archives of Neurology, 35, 364–367.Google Scholar
Bhalla, R. K., Papandonatos, G. D., Stern, R. A. and Ott, B. R. (2007). Anxiety of Alzheimer's disease patients before and after a standardized on-road driving test. Alzheimer's and Dementia, 3, 33–39.CrossRefGoogle ScholarPubMed
Bixby, K., Davis, J. D. and Ott, B. R. (2015). Comparing caregiver and clinician predictions of fitness to drive in people with Alzheimer's disease. American Journal of Occupational Therapy, 69. Doi: 6903270030CrossRefGoogle ScholarPubMed
Brown, L. B., Ott, B. R., Papandonatos, G. D., Sui, Y., Ready, R. E. and Morris, J. C. (2005). Prediction of on-road driving performance in patients with early Alzheimer's disease. Journal of the American Geriatrics Society, 53, 94–98.CrossRefGoogle ScholarPubMed
Carvalho, J. O., Ready, R. E., Malloy, P. and Grace, J. (2013). Confirmatory factor analysis of the frontal systems behavior scale (FrSBe). Assessment, 20, 632–641.Google Scholar
Cushman, L. A. (1996). Cognitive capacity and concurrent driving performance in older drivers. In Highway Capacity Manual, Sixth Edition: A Guide for Multimodal Mobility Analysis, (pp. 38–45). Washington, DC: The National Academies of Sciences, Engineering, and Medicine.Google Scholar
Daigneault, G., Joly, P. and Frigon, J. Y. (2002). Previous convictions or accidents and the risk of subsequent accidents of older drivers. Accident Analysis & Prevention, 34, 257–261.Google Scholar
Davis, J. D. et al. (2012). Road test and naturalistic driving performance in healthy and cognitively impaired older adults: does environment matter?. Journal of the American Geriatrics Society, 60, 2056–2062.Google Scholar
de Raedt, R. and Ponjaert-Kristoffersen, I. (2000). The relationship between cognitive/neuropsychological factors and car driving performance in older adults. Journal of the American Geriatrics Society, 48, 1664–1668.Google Scholar
De Raedt, R. and Ponjaert-Kristoffersen, I. (2001). Short cognitive/neuropsychological test battery for first-tier fitness-to-drive assessment of older adults. The Clinical Neuropsychologist, 15, 329–336.Google Scholar
Federal Highway Administration (FHWA). (2009). National Household Travel Survey and National Personal Transportation Survey. US Department of Transportation, Washington, DC.Google Scholar
Federal Highway Administration (FHWA). (2014). Highway Statistics Series. US Department of Transportation, Washington, DCGoogle Scholar
Fitten, L. J. et al. (1995). Alzheimer and vascular dementias and driving: a prospective road and laboratory study. Journal of the American Medical Association, 273, 1360–1365.Google Scholar
Foley, D. J., Wallace, R. B. and Eberhard, J. (1995). Risk factors for motor vehicle crashes among older drivers in a rural community. Journal of the American Geriatrics Society, 43, 776–781.Google Scholar
Folstein, M. F., Folstein, S. F. and McHugh, P. R. (1975). ‘Mini-mental State’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Fox, G. K., Bowden, S. C., Bashford, G. M. and Smith, D. S. (1997). Alzheimer's disease and driving: prediction and assessment of driving performance. Journal of the American Geriatrics Society.Google Scholar
Gebers, M. A. and Peck, R. C. (1992). The identification of high-risk older drivers through age-mediated point systems. Journal of Safety Research, 23, 81–93.Google Scholar
Grace, J., Amick, M. M., D'Abreu, A., Festa, E. K., Heindel, W. C. and Ott, B. R. (2005). Neuropsychological deficits associated with driving performance in Parkinson's and Alzheimer's disease. Journal of the International Neuropsychological Society, 6, 766–775.Google Scholar
Grace, J. and Malloy, P. (2001). The Frontal Systems Behavior Scale Manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
Herrmann, N., Rapoport, M. J., Sambrook, R., Hebert, R., McCracken, P. and Robillard, A. (2006). Predictors of driving cessation in mild-to-moderate dementia. Canadian Medical Association Journal, 175, 591–595.Google Scholar
Hoggarth, P. A., Innes, C. R., Dalrymple-Alford, J. C. and Jones, R. D. (2013). Predicting on-road assessment pass and fail outcomes in older drivers with cognitive impairment using a battery of computerized sensory-motor and cognitive tests. Journal of the American Geriatrics Society, 61, 2192–2198.Google Scholar
Hunt, L., Morris, J. C., Edwards, D. and Wilson, B. S. (1993). Driving performance in persons with mild senile dementia of the Alzheimer type. Journal of the American Geriatrics Society, 41, 747–752.CrossRefGoogle ScholarPubMed
Iverson, D. J., Gronseth, G. S., Reger, M. A., Classen, S., Dubinsky, R. M. and Rizzo, M. (2010). Practice parameter update: evaluation and management of driving risk in dementia report of the quality standards subcommittee of the American academy of neurology. Neurology, 74, 1316–1324.Google Scholar
Jurica, P. J., Leitten, C. L. and Mattis, S. (2004). DRS-2 Dementia Rating Scale-2: Professional Manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
Kahane, C. J. (2013). Injury vulnerability and effectiveness of occupant protection technologies for older occupants and women. In Report No. DOT-HS-811-766. National Highway Traffic Safety Administration, Washington, DC.Google Scholar
Keall, M. D. and Frith, W. J. (2004). Older driver crash rates in relation to type and quantity of travel. Traffic Injury Prevention, 5, 26–36.Google Scholar
Lesikar, S. E., Gallo, J. J., Rebok, G. W. and Keyl, P. M. (2002). Prospective study of brief neuropsychological measures to assess crash risk in older primary care patients. The Journal of the American Board of Family Practice, 15, 11–19.Google Scholar
MacGregor, J. M., Freeman, D. H. and Zhang, D. (2001). A traffic sign recognition test can discriminate between older drivers who have and have not had a motor vehicle crash. Journal of the American Geriatrics Society, 49, 466–469.Google Scholar
Malloy, P., Tremont, G., Grace, J. and Frakey, L. (2003). The frontal systems behavior scale discriminate frontotemporal dementia from Alzheimer's disease. Alzheimer's and Dementia, 3, 200–203.Google Scholar
McGwin, G., Sims, R. V., Pulley, L. and Roseman, J. M. (2000). Relations among chronic medical conditions, medications, and automobile crashes in the elderly: a population-based case-control study. American Journal of Epidemiology, 152, 424–431.CrossRefGoogle ScholarPubMed
McKhann, G. et al. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer's disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Mitrushina, M. and Satz, P. (1991). Reliability and validity of the mini-mental state exam in neurologically intact elderly. Journal of Clinical Psychology, 47, 537–543.Google Scholar
Morris, J. C. (1993). The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43, 2412–2414.Google Scholar
O'Connor, D. W. et al. (1989). The reliability and validity of the mini-mental state in a British community survey. Journal of Psychiatric Research, 23, 87–96.Google Scholar
Odenheimer, G. L., Beaudet, M., Jette, A. M., Albert, M. S., Grande, L. and Minaker, K. L. (1994). Performance-based driving evaluation of the elderly driver: safety, reliability, and validity. Journal of Gerontology, 49, M153–M159.Google Scholar
Ott, B. R., Heindel, W. C., Whelihan, W. M., Caron, M. D., Piatt, A. L. and Noto, R. B. (2000). A SPECT imaging study of driving impairment in patients with Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 11, 153–160.Google Scholar
Owsley, C. et al. (1998). Visual processing impairment and risk of motor vehicle crash among older adults. Journal of the American Medical Association, 279, 1083–1088.Google Scholar
Petersen, R. C. (1995). Normal aging, mild cognitive impairment, and early Alzheimer's disease. Neurologist, 1, 326–344.Google Scholar
Schmand, B., Lindeboom, J., Launer, L., Dinkgreve, M., Hooijer, C. and Jonker, C. (1995). What is a significant score change on the mini-mental state examination?. International Journal of Geriatric Psychiatry, 10, 411–414.Google Scholar
Schreiner, A. S., Morimoto, T., Arai, Y. and Zarit, S. (2006). Assessing family caregiver's mental health using a statistically derived cut-off score for the Zarit Burden Interview. Aging and Mental Health, 10, 107–111.Google Scholar
Staplin, L., Lococo, K. H., Gish, K. W. and Decina, L. E. (2003). Model driver screening and evaluation program, final technical report. Volume II: Maryland pilot older driver study (No. HS-809 583), United States Department of Transportation.Google Scholar
Stern, R. A. et al. (1994). The Boston qualitative scoring system for the Rey-Osterrieth complex figure: description and interrater reliability. The Clinical Neuropsychologist, 8, 309–322.Google Scholar
Stout, J. C., Ready, R. E., Grace, J., Malloy, P. F. and Paulsen, J. S. (2003). Factor analysis of the frontal systems behavior scale (FrSBe). Assessment, 10, 79–85.Google Scholar
US Census Bureau. (2012). Projections of the Population by Age and Sex for the United States: 2015 to 2060 (NP2012-T12). US Census Bureau, Washington, DC.Google Scholar
US Census Bureau. (2013). Annual Estimates of the Resident Population by Single Year of Age and Sex for the United States: April 1, 2010 to July 1, 2012. US Census Bureau, Washington, DC.Google Scholar
US Census Bureau. (2016). Quick Facts, 2016 Rhode Island Estimates. Available at: http://www.census.gov/quickfacts/table/PST045215/44.Google Scholar
Wild, K. and Cotrell, V. (2003). Identifying driving impairment in Alzheimer disease: a comparison of self and observer reports versus driving evaluation. Alzheimer Disease & Associated Disorders, 17, 27–34.Google Scholar
Zarit, S. H., Todd, P. A. and Zarit, J. M. (1986). Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist, 26, 260–266.Google Scholar