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In-person license renewal helps reduce dementia-related motor vehicle crashes

| Thursday, Feb. 1, 2018, 1:01 p.m.
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It's a question many of us have faced, or will face.

When is the right time to ask an older relative, friend, or even yourself, to surrender the car keys and stop driving?

That's the issue a new study from the University of Pittsburgh's Graduate School of Health aims to shed light on. Laws requiring physicians to report patients with dementia to state driver's licensing authorities do not necessarily mean fewer hospitalizations from motor vehicle crashes, the study said.

“It's an issue of safety and injury,” said co-author Yll Agimi, a health data scientist at Salient CGRT Inc., a Fairfax, Va. company whose services include health analytics. Agimi, who did the study research while a doctoral student at Pitt Public Health, co-authored the study with Steven Albert, chair and professor of the Department of Behavioral and Community Health Sciences at Pitt Public Health.

The study found in-person license renewal laws and vision testing tend to dramatically reduce the number of motor vehicle accidents by drivers with dementia. The chance of developing dementia increases with age, from 9 percent in adults age 65 and older to 30 percent in people 85 and older, the study said.

Agimi, Albert and their colleagues analyzed motor-vehicle-related hospital admissions from states reporting that data between 2004 and 2009. Among the 136,987 hospitalized older drivers, 5,564 had a diagnosis of dementia.

At the time the study was done, only Pennsylvania, Oregon and California required doctors to report drivers with dementia to licensing authorities. Twenty-seven states provide legal protection to physicians who report their dementia patients to licensing authorities, regardless of whether it is required by law.

The study, which has been published in Neurology, the medical journal of the American Academy of Neurology, found physician reporting laws are not working, or lack any tangible safety benefits.

According to the Pennsylvania Department of Transportation, around 27,000 drivers with medical issues that could affect their driving abilities are reported each year. Approximately 22 percent of those drivers have a medical impairment significant enough to merit a recall of their driving privilege, and half are under the age of 65.

Hospitalized drivers between the ages of 60 to 69 who live in states with in-person renewal laws were 37 to 38 percent less likely to have dementia than drivers in states without such laws, the study said.

Albert said study results show aged-based licensing requirements are an effective way to improve driver safety. He also said many times physicians may have developed a relationship with the patient and may have difficulty reporting the condition to licensing authorities.

“But such requirements also may cause social isolation and depression, and may be seen as ageist and discriminatory,” Albert said in a statement. “So it is very important that our findings spur further study to determine the best approach to ensure safe driving for all on the road while avoiding a negative impact on the mental health of older adults.”

Suzanne Elliott is a Tribune-Review staff writer. She can be reached at or 412-871-2346.

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