Advertisement

Driving decision-making among older adults with dementia in Taiwan: A longitudinal study

  • Mu-Hsing Ho
    Affiliations
    School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
    Search for articles by this author
  • Hui-Wen Chien
    Affiliations
    Department of Nursing and Graduate Institute of Nursing, Asia University, Taichung, Taiwan
    Search for articles by this author
  • Wei-Chuan Tsai
    Affiliations
    Chu Shang Show Chwan Hospital, Nantou, Taiwan
    Search for articles by this author
  • Ying-Ju Chi
    Affiliations
    Chu Shang Show Chwan Hospital, Nantou, Taiwan
    Search for articles by this author
  • Li-Yu Tang
    Affiliations
    Taiwan Alzheimer's Disease Association, Taipei, Taiwan
    Search for articles by this author
  • Victoria Traynor
    Affiliations
    School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia

    Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, NSW, Australia
    Search for articles by this author
  • Author Footnotes
    † Megan F. Liu and Hui-Chen (Rita) Chang contributed equally to this manuscript.
    Megan F. Liu
    Footnotes
    † Megan F. Liu and Hui-Chen (Rita) Chang contributed equally to this manuscript.
    Affiliations
    School of Gerontology Health Management, Taipei Medical University, Taipei, Taiwan
    Search for articles by this author
  • Author Footnotes
    † Megan F. Liu and Hui-Chen (Rita) Chang contributed equally to this manuscript.
    Hui-Chen (Rita) Chang
    Correspondence
    Corresponding author at: School of Gerontology Health Management, Taipei Medical University, Taipei, Taiwan, 250 Wu-Hsing Street, Taipei city, Taiwan 11031, Tel.: +886 27361661 ext 6341 (MFL); School of Nursing, University of Wollongong, Northfields Ave., Wollongong, NSW, 2522, Australia, Tel.: +61 242213174 (HCC).
    Footnotes
    † Megan F. Liu and Hui-Chen (Rita) Chang contributed equally to this manuscript.
    Affiliations
    School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia

    Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, NSW, Australia
    Search for articles by this author
  • Author Footnotes
    † Megan F. Liu and Hui-Chen (Rita) Chang contributed equally to this manuscript.

      Abstract

      Background

      Driving is a complex skill that requires the integration of cognition and motor functions. However, these functions are all impacted by dementia.

      Aim

      We investigated the driving status among persons with dementia and the effects of a Dementia and Driving Decision Aid (DDDA) on changes in driving decisions, depressive symptoms and anxiety.

      Methods

      A longitudinal study with a 6-month observation was undertaken. Participants were clients in an Integrated Dementia Care Center (IDCC) who were diagnosed with a mild dementia. The primary outcome was changes in driving decisions; secondary outcomes included depressive symptoms, anxiety, and views on the booklet. Data were collected at four time points: baseline (T0), and 1 month (T1), 3 months (T2), 6 months (T3) after implementing DDDA. A logistic regression was used to examine changes in driving decisions, and a repeated-measures ANOVA was adopted to compare changes in secondary outcomes across time.

      Findings

      The number of participants who decided to continue driving significantly decreased (p < 0.001), while those who decided to drive less significantly increased (p < 0.001). A significant improvement in depressive symptoms was found in participants over time (F = 9.192; p < 0.001), the mean scores at all post-test time points were lower compared to the baseline measure.

      Discussion

      We report successful implementation of a DDDA booklet in an IDCC in Taiwan. In addition, participants’ satisfaction level toward the booklet was high.

      Conclusion

      We suggest the DDDA booklet can be widely utilised in community-based dementia care centres.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Collegian
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Aged Dementia Health Education and Research
        Dementia and driving education module. 2021; (Retrieved 19 Dec from)
        • Beck A.T.
        • Epstein N.
        • Brown G.
        • Steer R.A.
        An inventory for measuring clinical anxiety: Psychometric properties.
        Journal of Consulting and Clinical Psychology. 1988; 56: 893-897https://doi.org/10.1037//0022-006x.56.6.893
        • Braun V.
        • Clarke V.
        Using thematic analysis in psychology.
        Qualitative Research in Psychology. 2006; 3: 77-101https://doi.org/10.1191/1478088706qp063oa
        • Carmody J.
        • Potter J.
        • Lewis K.
        • Bhargava S.
        • Traynor V.
        • Iverson D.
        Development and pilot testing of a decision aid for drivers with dementia.
        Bmc Medical Informatics and Decision Making [Electronic Resource]. 2014; 14https://doi.org/10.1186/1472-6947-14-19
      1. Carter, K., Monaghan, S., O'Brien, J., Teodorczuk, A., Mosimann, U., & Taylor, J.-P. (2015). Driving and dementia: a clinical decision pathway. 30(2), 210–216. doi:10.1002/gps.4132

        • Chang H.C.R.
        • Ho M.H.
        • Traynor V.
        • Tang L.Y.
        • Liu M.F.
        • Chien H.W.
        • et al.
        Mandarin version of dementia and driving decision aid (DDDA): Development and stakeholder evaluation in Taiwan.
        International Journal of Older People Nursing. 2021; 16: e12370https://doi.org/10.1111/opn.12370
        • Che H.H.
        • Lu M.L.
        • Chen H.C.
        • Chang S.W.
        • Lee Y.J.
        Validation of the Chinese version of the beck anxiety inventory [validation of the chinese version of the beck anxiety inventory].
        Journal of the Formosan Medical Association. 2006; 10: 447-454https://doi.org/10.6320/fjm.2006.10(4).05
        • Elwyn G.
        • O'Connor A.
        • Stacey D.
        • Volk R.
        • Edwards A.
        • Coulter A.
        • et al.
        Developing a quality criteria framework for patient decision aids: Online international Delphi consensus process.
        BMJ. 2006; 333: 417https://doi.org/10.1136/bmj.38926.629329.AE
        • Greenberg S.A.
        How to try this: the geriatric depression scale: short form.
        American Journal of Nursing. 2007; 107 (quiz 69-70): 60-69https://doi.org/10.1097/01.NAJ.0000292204.52313.f3
        • Ho M.H.
        • Chang H.R.
        • Liu M.F.
        • Chien H.W.
        • Tang L.Y.
        • Chan S.Y.
        • et al.
        Decision-making in people with dementia or mild cognitive impairment: a narrative review of decision-making tools.
        Journal of the American Medical Directors Association. 2021; 22 (e2054): 2056-2062https://doi.org/10.1016/j.jamda.2021.06.034
        • Hsiao Y.-H.
        • Kuo T.A.
        • Tai C.-J.
        • Lee S.-S.
        • Lee M.-C.
        Integrated care for dementia in Taiwan: policy.
        System and Services. 2019; (Special Issue): s73-s77https://doi.org/10.6890/ijge.201910/sp.0012
        • Hung L.
        • Hudson A.
        • Gregorio M.
        • Jackson L.
        • Mann J.
        • Horne N.
        • et al.
        Creating dementia-friendly communities for social inclusion: a scoping review.
        Gerontology & Geriatric Medicine. 2021; 723337214211013596https://doi.org/10.1177/23337214211013596
        • Lazeras C.
        • Cartier M.
        • Bonnet M.
        • Laurens B.
        • Meissner W.G.
        • Planche V.
        Why and how to evaluate driving abilities in patients with neurodegenerative diseases?.
        Geriatrie et Psychologie Neuropsychiatrie du Vieillissement. 2021; https://doi.org/10.1684/pnv.2021.0975
        • Liu S.H.
        • Chang C.C.
        • Hu C.J.
        • Ho M.H.
        • Chang H.R.
        • Chien H.W.
        • et al.
        [Driving cessation and mental health in persons with dementia: a preliminary study].
        Hu Li Za Zhi the Journal of Nursing. 2021; 68: 43-52https://doi.org/10.6224/jn.202108_68(4).06
        • Minister of Transportation and Communications
        Regulations for older drivers by the Directorate General of Highwats. 2021; (Retrieved 20 Dec from)
        • Minister of Transportation and Communications
        Road traffic accident statistics. 2021; (Retrieved 19 Dec from)
        • Ministry of Health and Welfare
        Taiwan dementia policy.
        A Framework for Prevention and Care. 2014; (Retrieved 02 Dec from)
      2. Minitry of Health and Welfare. (2018). Dementia prevention and care policy and action plan 2.0: 2018-2025. Retrieved 02 Dec from https://www.mohw.gov.tw/dl-51182-b894344f-f241-4f7b-adc2-e3a6644d9fb1.html

        • Skyving M.
        • Forsman Å.
        • Dukic Willstrand T.
        • Laflamme L.
        • Möller J.
        Medical impairment and road traffic crashes among older drivers in Sweden - A national, population-based, case-control study.
        Accident Analysis and Prevention. 2021; 163106434https://doi.org/10.1016/j.aap.2021.106434
        • Stacey D.
        • Légaré F.
        • Lewis K.
        • Barry M.J.
        • Bennett C.L.
        • Eden K.B.
        • et al.
        Decision aids for people facing health treatment or screening decisions.
        Cochrane Database of Systematic Reviews (Online). 2017; 4Cd001431https://doi.org/10.1002/14651858.CD001431.pub5
        • Stamatelos P.
        • Economou A.
        • Stefanis L.
        • Yannis G.
        • Papageorgiou S.G.
        Driving and Alzheimer's dementia or mild cognitive impairment: A systematic review of the existing guidelines emphasizing on the neurologist's role.
        Neurological Sciences. 2021; 42: 4953-4963https://doi.org/10.1007/s10072-021-05610-7
      3. Stasiulis, E., Rapoport, M. J., Sivajohan, B., & Naglie, G. (2020). The paradox of dementia and driving cessation: "it's a hot topic," "always on the back burner". Gerontologist, 60(7), 1261–1272. doi:10.1093/geront/gnaa034.

        • Yesavage J.A.
        • Brink T.L.
        • Rose T.L.
        • Lum O.
        • Huang V.
        • Adey M.
        • et al.
        Development and validation of a geriatric depression screening scale: a preliminary report.
        Journal of Psychiatric Research. 1982; 17: 37-49https://doi.org/10.1016/0022-3956(82)90033-4
        • Zhao H.
        • He J.
        • Yi J.
        • Yao S.
        Factor structure and measurement invariance across gender groups of the 15-item geriatric depression scale among chinese elders.
        Frontiers in Psychology. 2019; 10 (–1360): 1360https://doi.org/10.3389/fpsyg.2019.01360