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February 27, 2018; 90 (9) Article

Dementia and motor vehicle crash hospitalizations

Role of physician reporting laws

Yll Agimi, Steven M. Albert, Ada O. Youk, Patricia I. Documet, Claudia A. Steiner
First published January 31, 2018, DOI: https://doi.org/10.1212/WNL.0000000000005022
Yll Agimi
From Salient CRGT Inc. (Y.A.), Health Services, Silver Spring, MD; Departments of Behavioral and Community Health Sciences (S.M.A., P.I.D.) and Biostatistics (A.O.Y.), University of Pittsburgh, PA; Kaiser Permanente-Denver (C.A.S.), Institute for Health Research, CO; Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (C.A.S.), DHHS, Rockville, MD.
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Steven M. Albert
From Salient CRGT Inc. (Y.A.), Health Services, Silver Spring, MD; Departments of Behavioral and Community Health Sciences (S.M.A., P.I.D.) and Biostatistics (A.O.Y.), University of Pittsburgh, PA; Kaiser Permanente-Denver (C.A.S.), Institute for Health Research, CO; Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (C.A.S.), DHHS, Rockville, MD.
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Ada O. Youk
From Salient CRGT Inc. (Y.A.), Health Services, Silver Spring, MD; Departments of Behavioral and Community Health Sciences (S.M.A., P.I.D.) and Biostatistics (A.O.Y.), University of Pittsburgh, PA; Kaiser Permanente-Denver (C.A.S.), Institute for Health Research, CO; Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (C.A.S.), DHHS, Rockville, MD.
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Patricia I. Documet
From Salient CRGT Inc. (Y.A.), Health Services, Silver Spring, MD; Departments of Behavioral and Community Health Sciences (S.M.A., P.I.D.) and Biostatistics (A.O.Y.), University of Pittsburgh, PA; Kaiser Permanente-Denver (C.A.S.), Institute for Health Research, CO; Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (C.A.S.), DHHS, Rockville, MD.
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Claudia A. Steiner
From Salient CRGT Inc. (Y.A.), Health Services, Silver Spring, MD; Departments of Behavioral and Community Health Sciences (S.M.A., P.I.D.) and Biostatistics (A.O.Y.), University of Pittsburgh, PA; Kaiser Permanente-Denver (C.A.S.), Institute for Health Research, CO; Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (C.A.S.), DHHS, Rockville, MD.
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Citation
Dementia and motor vehicle crash hospitalizations
Role of physician reporting laws
Yll Agimi, Steven M. Albert, Ada O. Youk, Patricia I. Documet, Claudia A. Steiner
Neurology Feb 2018, 90 (9) e808-e813; DOI: 10.1212/WNL.0000000000005022

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Abstract

Objective To determine the effect of physician reporting laws and state licensing requirements on crash hospitalizations among drivers with dementia.

Methods A study of drivers hospitalized because of vehicle crashes, identified from the State Inpatient Databases of the Agency for Healthcare Research and Quality. Multivariable logistic regression was used to examine the effect of mandatory physician reporting of at-risk drivers and state licensing requirement on the prevalence of dementia among hospitalized drivers.

Results Physician reporting laws, mandated or legally protected, were not associated with a lower likelihood of dementia among crash hospitalized drivers. Hospitalized drivers aged 60 to 69 years in states with in-person renewal laws were 37% to 38% less likely to have dementia than drivers in other states and 23% to 28% less likely in states with vision testing at in-person renewal. Road testing was associated with lower dementia prevalence among hospitalized drivers aged 80 years and older.

Conclusion Vision testing at in-person renewal and in-person renewal requirements were significantly related with a lower prevalence of dementia in hospitalized older adults among drivers aged 60 to 69 years. Road testing was significantly associated with a lower proportion of dementia among hospitalized drivers aged 80 years and older. Mandatory physician driver reporting laws lacked any independent association with prevalence of dementia among hospitalized drivers.

Glossary

AD=
Alzheimer disease;
AHRQ=
Agency for Healthcare Research and Quality;
CI=
confidence interval;
DSM-V=
Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition);
GEE=
generalized estimating equation;
HCUP=
Healthcare Cost and Utilization Project;
ICD-9-CM=
International Classification of Diseases, Ninth Revision, Clinical Modification

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received May 29, 2017.
  • Accepted in final form December 1, 2017.
  • © 2018 American Academy of Neurology
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