Computer-Based Driving in Dementia Decision Tool With Mail Support: Cluster Randomized Controlled Trial.

Area of Science:

• Geriatric Medicine
• Neurology
• Transportation Safety

Background:

• Physicians face challenges assessing driving ability in individuals with mild cognitive impairment (MCI) and mild dementia.
• Balancing patient safety, road safety, and reporting consequences is crucial.

Purpose of the Study:

• To evaluate if a computer-based Driving in Dementia Decision Tool (DD-DT) improved appropriate reporting of patients with MCI or mild dementia to transportation authorities.

Main Methods:

• A randomized controlled trial tested a multifaceted intervention including the DD-DT decision support system.
• The intervention group received the DD-DT, educational materials, and specialized reporting forms.
• The control group received a generic reminder about reporting legislation.

Main Results:

• The proportion of patients reported concordant with algorithmic recommendations did not differ between the DD-DT and control groups (50% vs. 49%).
• Caregiver concern (OR=5.8) and abnormal clock drawing tests (OR=6.1) significantly predicted algorithm-based reporting.

Conclusions:

• The DD-DT did not increase physician reporting rates for patients with MCI or mild dementia.
• Physician decisions to report were substantially influenced by caregiver concerns and abnormal clock drawing results.