{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T06:49:34Z","timestamp":1788590974286,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T00:00:00Z","timestamp":1605225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014791","name":"Iowa Department of Transportation","doi-asserted-by":"publisher","award":["DTNH2216RQ-00556"],"award-info":[{"award-number":["DTNH2216RQ-00556"]}],"id":[{"id":"10.13039\/100014791","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005217","name":"National Center for Injury Prevention and Control","doi-asserted-by":"publisher","award":["R49CE002108"],"award-info":[{"award-number":["R49CE002108"]}],"id":[{"id":"10.13039\/100005217","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Cognitive and physical impairment can occur with dementia and reduce driving ability. In the United States, individual states have procedures to refer and evaluate drivers who may no longer be fit to drive. The license review process is not well understood for drivers with dementia. This study uses comprehensive data from the Iowa Department of Transportation to compare the referral process for drivers with and without dementia from January 2014 through November 2019. The likelihood of failing an evaluation test was compared between drivers with and without dementia using logistic regression. The risk of motor-vehicle crash after referral for review of driving ability was compared using a Cox proportional hazard model. Analysis controlled for the age and sex of the referred driver. Drivers with dementia performed worse on all tests evaluated except the visual screening test. After the referral process, the risk of crash was similar between those with and without dementia. Drivers with dementia were denied their license more frequently than referred drivers without dementia. However, drivers with dementia who successfully kept their license as a result of the license review process were not at an increased risk of crash compared to other referred drivers.<\/jats:p>","DOI":"10.3390\/geriatrics5040091","type":"journal-article","created":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T08:44:02Z","timestamp":1605257042000},"page":"91","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Medical Referral Process and Motor-Vehicle Crash Risk for Drivers with Dementia"],"prefix":"10.3390","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5164-1241","authenticated-orcid":false,"given":"Jonathan","family":"Davis","sequence":"first","affiliation":[{"name":"University of Iowa Injury Prevention Research Center, 2190 Westlawn, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8916-7285","authenticated-orcid":false,"given":"Cara","family":"Hamann","sequence":"additional","affiliation":[{"name":"University of Iowa Injury Prevention Research Center, 2190 Westlawn, Iowa City, IA 52242, USA"},{"name":"Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Butcher","sequence":"additional","affiliation":[{"name":"University of Iowa Injury Prevention Research Center, 2190 Westlawn, Iowa City, IA 52242, USA"},{"name":"Department of Biostatistics, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Peek-Asa","sequence":"additional","affiliation":[{"name":"University of Iowa Injury Prevention Research Center, 2190 Westlawn, Iowa City, IA 52242, USA"},{"name":"Department of Occupational and Environmental Health, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jalz.2018.06.3063","article-title":"Racial and ethnic estimates of Alzheimer\u2019s disease and related dementias in the United States (2015\u20132060) in adults aged \u226565 years","volume":"15","author":"Matthews","year":"2019","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"713","DOI":"10.3233\/JAD-160276","article-title":"A Systematic Review and Meta-Analysis of On-Road Simulator and Cognitive Driving Assessment in Alzheimer\u2019s Disease and Mild Cognitive Impairment","volume":"53","author":"Hird","year":"2016","journal-title":"J. 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Clinician\u2019s Guide to Assessing and Counseling Older Drivers, National Highway Traffic Safety Administration. [3rd ed.]. (Report No. DOT HS 812 228)."}],"container-title":["Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3417\/5\/4\/91\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:32:47Z","timestamp":1760178767000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3417\/5\/4\/91"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,13]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["geriatrics5040091"],"URL":"https:\/\/doi.org\/10.3390\/geriatrics5040091","relation":{},"ISSN":["2308-3417"],"issn-type":[{"value":"2308-3417","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,13]]}}}