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

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 centers.