Kimberly Bixby, Jennifer D. Davis, Brian R. Ott; Comparing Caregiver and Clinician Predictions of Fitness to Drive in People With Alzheimer’s Disease. Am J Occup Ther 2015;69(3):6903270030. https://doi.org/10.5014/ajot.2015.013631
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© 2021 American Occupational Therapy Association
This observational study investigated family caregiver and clinician ratings of 75 drivers with Alzheimer’s disease against scores on a standardized road test and a naturalistic driving evaluation. Clinician ratings by a physician specialized in dementia were significantly associated with road test error scores (r = .25, p = .03) but not naturalistic driving errors or global ratings of road test and naturalistic driving performance. Caregiver ratings were unrelated to either driving assessment, with two exceptions; adult child ratings of driving ability were correlated with road test error scores (r = .43, p = .02), and spousal ratings were inversely correlated with global ratings. Clinician ratings of driving competence were modestly correlated with road test performance, but caregiver ratings were more complex. Adult children may be more accurate reporters of driving ability than spouses, possibly because of less personal bias, but the reasons behind this discrepancy need further investigation.
Use of a valid and reliable questionnaire of driving ability that addresses specific, rather than global, ratings of driving behaviors may provide valuable information when making decisions about fitness to drive with older adult clients with AD.
The validity of family member reports of driving ability may be weak, but in general adult children may be better informants than spouses. Gathering input from multiple family members may be beneficial when completing a driving evaluation.
Caregiver education programs could include training programs to help caregivers, especially spouses, recognize and monitor unsafe driving behaviors.
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