Skip to main content
×
×
Home

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

  • Janessa O. Carvalho (a1), Beth Springate (a2), Rachel A. Bernier (a3) and Jennifer Davis (a4)
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.

Copyright
Corresponding author
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.
References
Hide All
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, 270279.
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, 10381045.
Benton, A. L., Varney, N. R. and Hamsher, K. D. (1978). Visuospatial judgment. A clinical test. Archives of Neurology, 35, 364367.
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, 3339.
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: 6903270030
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, 9498.
Carvalho, J. O., Ready, R. E., Malloy, P. and Grace, J. (2013). Confirmatory factor analysis of the frontal systems behavior scale (FrSBe). Assessment, 20, 632641.
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. 3845). Washington, DC: The National Academies of Sciences, Engineering, and Medicine.
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, 257261.
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, 20562062.
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, 16641668.
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, 329336.
Federal Highway Administration (FHWA). (2009). National Household Travel Survey and National Personal Transportation Survey. US Department of Transportation, Washington, DC.
Federal Highway Administration (FHWA). (2014). Highway Statistics Series. US Department of Transportation, Washington, DC
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, 13601365.
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, 776781.
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, 189198.
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.
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, 8193.
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, 766775.
Grace, J. and Malloy, P. (2001). The Frontal Systems Behavior Scale Manual. Odessa, FL: Psychological Assessment Resources.
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, 591595.
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, 21922198.
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, 747752.
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, 13161324.
Jurica, P. J., Leitten, C. L. and Mattis, S. (2004). DRS-2 Dementia Rating Scale-2: Professional Manual. Odessa, FL: Psychological Assessment Resources.
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.
Keall, M. D. and Frith, W. J. (2004). Older driver crash rates in relation to type and quantity of travel. Traffic Injury Prevention, 5, 2636.
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, 1119.
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, 466469.
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, 200203.
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, 424431.
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, 939944.
Mitrushina, M. and Satz, P. (1991). Reliability and validity of the mini-mental state exam in neurologically intact elderly. Journal of Clinical Psychology, 47, 537543.
Morris, J. C. (1993). The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43, 24122414.
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, 8796.
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, M153M159.
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, 153160.
Owsley, C. et al. (1998). Visual processing impairment and risk of motor vehicle crash among older adults. Journal of the American Medical Association, 279, 10831088.
Petersen, R. C. (1995). Normal aging, mild cognitive impairment, and early Alzheimer's disease. Neurologist, 1, 326344.
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, 411414.
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, 107111.
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.
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, 309322.
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, 7985.
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.
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.
US Census Bureau. (2016). Quick Facts, 2016 Rhode Island Estimates. Available at: http://www.census.gov/quickfacts/table/PST045215/44.
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, 2734.
Zarit, S. H., Todd, P. A. and Zarit, J. M. (1986). Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist, 26, 260266.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed