{"id":19320,"date":"2024-04-26T14:25:21","date_gmt":"2024-04-26T21:25:21","guid":{"rendered":"https:\/\/dornsife.usc.edu\/news\/?p=19320"},"modified":"2026-03-03T08:55:53","modified_gmt":"2026-03-03T16:55:53","slug":"dementia-screening-mandates-for-elderly-drivers-may-backfire","status":"publish","type":"post","link":"https:\/\/dornsife.usc.edu\/news\/stories\/dementia-screening-mandates-for-elderly-drivers-may-backfire\/","title":{"rendered":"Laws requiring doctors to report a dementia diagnosis to the DMV may backfire"},"content":{"rendered":"\n\n\n    \n                                          \n\n  \n    \n\n\n\n\n\n\n<div\n  class=\"cc--component-container cc--article-hero \"\n\n  \n  \n  \n  \n  \n  \n  >\n  <div class=\"c--component c--article-hero\"\n    \n      >\n\n    \n<div class=\"inner-wrapper\">\n          \n<div class=\"f--field f--image\">\n\n    \n    \n    \n    \n    \n    \n              \n      <img\n                            data-src=\"https:\/\/dornsife.usc.edu\/news\/wp-content\/uploads\/sites\/7\/2024\/04\/Dementia_DMV_Top-768x432.png\"\n          data-srcset=\"https:\/\/dornsife.usc.edu\/news\/wp-content\/uploads\/sites\/7\/2024\/04\/Dementia_DMV_Top-1920x1080.png 1920w,https:\/\/dornsife.usc.edu\/news\/wp-content\/uploads\/sites\/7\/2024\/04\/Dementia_DMV_Top-1280x720.png 1280w,https:\/\/dornsife.usc.edu\/news\/wp-content\/uploads\/sites\/7\/2024\/04\/Dementia_DMV_Top-768x432.png 768w\"          data-sizes=\"(min-width:1200px) 75vw, (min-width:768px) 83vw, 100vw\"          class=\"lazyload\"\n        \n                  alt=\"Illustration of an elderly person driving\"\n        \n        \n                                      \/>\n\n    \n    \n  \n  \n\n<\/div>\n  \n      <div class=\"image-caption\">\n          \n<div class=\"f--field f--description\">\n\n    \n  The number of elderly drivers at risk of dementia is on the rise. (Image: Adobe Firefly.)\n\n\n<\/div>\n    <\/div>\n  \n  <div class=\"text-wrapper\">\n          <nav aria-label=\"Breadcrumb\" class=\"breadcrumbs\">\n        <ul>\n                      <li><a href=\"\/news\/stories\/\">News<\/a><\/li>\n                      <li><a href=\"\/news\/stories\/\/?category=health\">Health<\/a><\/li>\n                  <\/ul>\n      <\/nav>\n    \n              \n<div class=\"f--field f--page-title\">\n\n    \n  <h1>Laws requiring doctors to report a dementia diagnosis to the DMV may backfire<\/h1>\n\n\n<\/div>\n    \n          <div class=\"subtitle\">\n            \n<div class=\"f--field f--description\">\n\n    \n  As the number of drivers 65 and older rises, USC Dornsife researchers investigate for the first time whether state DMV reporting mandates are associated with clinicians\u2019 likelihood of underdiagnosing Alzheimer\u2019s disease and other forms of dementia.\n\n\n<\/div>\n      <\/div>\n    \n           <strong class=\"author-field\"><span >By<\/span><a href=\"mailto:communication@dornsife.usc.edu\">Ileana Wachtel<\/a><\/strong>\n    \n          <span class=\"post-date-field\">April 26, 2024<\/span>\n      <\/div>\n<\/div>\n\n\n  <\/div><\/div>\n\n  \n    \n\n\n\n\n\n\n<div\n  class=\"cc--component-container cc--social-share \"\n\n  \n  \n  \n  \n  \n  \n  >\n  <div class=\"c--component c--social-share\"\n    \n      >\n\n    \n  <div class=\"content-wrapper\">\n    <span class=\"a2a_kit a2a_kit_size_32 addtoany_list\" style=\"line-height: 32px;\">\n      <span class=\"title\">\n        Share\n      <\/span>\n                        <a class=\"a2a_button_copy_link\" target=\"_blank\" href=\"\/#copy_link\" rel=\"nofollow noopener\" title=\"Link\">\n            <span class=\"a2a_svg a2a_s__default a2a_s_copy_link\">\n              <svg height=\"19\" viewBox=\"0 0 19 19\" width=\"19\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"m7.43475275 9.52380952-2.17490843 2.26076008c-1.08745421 1.058837-1.68841575 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<p><strong>Some states require that physicians<\/strong> report a diagnosis of dementia, including Alzheimer\u2019s disease, to the DMV. A new study suggests these mandates may have unintended consequences.<\/p>\n<p><strong>Published April 25<\/strong> in the <em>Journal of the American Medical Association<\/em>\u2019s <em>JAMA Network Open<\/em>, <a href=\"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.8889\" target=\"_blank\" rel=\"noopener\">the study<\/a> was led by researchers at the USC Dornsife College of Letters, Arts and Sciences in collaboration with a Harvard University researcher.<\/p>\n<p><strong>Why it matters:<\/strong> The <a href=\"https:\/\/www.nhtsa.gov\/road-safety\/older-drivers\" target=\"_blank\" rel=\"noopener\">increasing number<\/a> of elderly drivers presents significant safety concerns for policymakers, physicians and society, considering they\u2019re at greater risk of dementia. But no studies have examined the effects of state policies that require clinicians to report dementia cases to the DMV \u2014 until now.<\/p>\n<ul>\n<li>Previous studies that explored the connection between cognitive decline and road safety found contradictory evidence regarding dementia\u2019s link to accidents.<\/li>\n<li>One potential explanation for this is that researchers hadn\u2019t factored in DMV reporting requirements.<\/li>\n<\/ul>\n<p><strong>At issue:<\/strong> For the new study, the researchers sought to determine whether physicians who are mandated by the DMV to report a diagnosis of dementia will be less likely to establish such a diagnosis. The short answer seems to be \u201cyes.\u201d<\/p>\n<ul>\n<li>The study is the first to provide evidence for potential negative consequences of laws that mandate physicians report dementia diagnoses to the DMV.<\/li>\n<\/ul>\n<p><strong>Key finding<\/strong><strong>:<\/strong> \u00a0Physicians in states with mandatory reporting laws are 50% more likely to <em>under<\/em>diagnose dementia, compared to physicians in states without such mandates.<\/p>\n<p><strong>The Big Picture:<\/strong> In the United States, the number of drivers aged 65 and older has increased by 22% since 2012, totaling nearly 56 million in 2021.<\/p>\n<ul>\n<li>About 7 million Americans in this age group currently suffer from dementia. That number is expected to increase to nearly 12 million by 2040.<\/li>\n<\/ul>\n<p><strong>Important:<\/strong> If patients withhold symptoms out of fear their doctor will report a dementia diagnosis to the DMV,or physicians are reluctant to examine dementia symptoms for fear their patient could lose their driving license, that would worsen health outcomes and increase health care costs.<\/p>\n<ul>\n<li>\u201cIn light of our findings, lawmakers need to weigh the potential downside of mandating that physicians report dementia diagnoses to the DMV,\u201d said Soeren Mattke, professor (research) of economics and director of the Brain Health Observatory at the USC Dornsife <a href=\"https:\/\/dornsife.usc.edu\/cesr\/\">Center for Economic and Social Research<\/a> (CESR).<\/li>\n<\/ul>\n<p><strong>What else?<\/strong> Knowing that their physicians must report a dementia diagnosis to the DMV, patients might be more inclined to refuse further assessments.<\/p>\n<ul>\n<li>The loss of a driver\u2019s license adds to the stigma associated with dementia.<\/li>\n<li>Studies also suggest that older adults without a driver\u2019s license engage in fewer out-of-home activities and have a higher risk of depression.<\/li>\n<\/ul>\n<p><strong>In her words:<\/strong> \u201cPatients already resist revealing symptoms of cognitive decline. Facing the threat of losing their driving privileges could make them less likely to seek essential cognitive evaluation, leading to more overlooked or postponed diagnoses,\u201d said <a href=\"https:\/\/cesr.usc.edu\/people\/staff\/liu385\">Ying Liu<\/a>, a research scientist at CESR and co-author of the study.<\/p>\n<p><strong>In dispute:<\/strong> There is scant evidence that mandatory reporting laws reduce accident risks. States enact mandatory reporting laws believing they can enhance driving safety.<\/p>\n<ul>\n<li>The researchers looked for studies on the association between mandatory reporting policies and accidents from 2000 to 2023 and found only one. That study found no significant difference in dementia rates among older drivers hospitalized after accidents in states with physician-reporting laws compared to other states.<\/li>\n<li>Studies using driving simulators show that cognitive impairment correlates with decreased perception, visual attention and reaction time. Whether these changes increase the risk of accidents remains unclear.<\/li>\n<\/ul>\n<p><strong>The\u00a0lack of evidence<\/strong> hinders researchers\u2019 ability to determine whether the benefits of reporting mandates outweigh the risks associated with the increase in missed diagnoses.<\/p>\n<ul>\n<li>Mattke suggests that people with cognitive decline may voluntarily change their behavior, such as driving less or avoiding driving at night, to mitigate the risk of accidents.<\/li>\n<\/ul>\n<p><strong>Zoom in:<\/strong> The diverse range of state policies regarding the mandatory reporting of dementia reflects the complexity and varying interpretations of the evidence.<\/p>\n<ul>\n<li>Four states \u2014 California, Delaware, Oregon and Pennsylvania \u2014 mandate under threat of legal consequences that physicians report diagnoses of dementia to their DMVs.<\/li>\n<li>New Jersey and Nevada require clinicians to report medical conditions that could pose a potential threat to road safety, though they do not explicitly mention Alzheimer\u2019s disease or cognitive impairment.<\/li>\n<li>Fourteen states ask drivers to self-report dementia diagnoses, which typically triggers a medical examination or driving test.<\/li>\n<li>The remaining 32 states and the District of Columbia have no mandates but allow physicians \u2014 as well as family members and police officers \u2014 to report dementia diagnoses. (Maryland, New Mexico and Texas accept reports )<\/li>\n<\/ul>\n<p><strong>Study methods<\/strong>: The researchers, analyzing Medicare data used for a <a href=\"https:\/\/dornsife.usc.edu\/news\/stories\/hidden-crisis-of-mild-cognitive-impairment\/\">previous study<\/a> on mild cognitive impairment diagnoses, classified states based on their reporting laws.<\/p>\n<ul>\n<li>The team sorted more than 223,000 primary care clinicians into three groups: mandated clinician reporting; mandated self-reporting; and no explicit requirements.<\/li>\n<li>They then analyzed the relationship between these categories and the likelihood of primary care clinicians underdiagnosing dementia among their patients.<\/li>\n<\/ul>\n<p><strong>What\u2019s next?<\/strong> Mattke and his team say future study is needed to better understand the unintended consequences and risk-benefit tradeoffs of these policies.<\/p>\n\n\n\n<\/div>\n\n\n  <\/div><\/div>\n\n\n\n  \n        \n  \n    \n\n\n\n\n\n\n<div\n  class=\"cc--component-container cc--article-related-stories \"\n\n  \n  \n  \n  \n  \n  \n  >\n  <div class=\"c--component c--article-related-stories\"\n    \n      >\n\n    \n  <div class=\"inner-wrapper\">\n              \n<div class=\"f--field f--section-title\">\n\n    \n  <h2>\n          Related Articles\n      <\/h2>\n\n\n<\/div>\n    \n                  <article>\n              \n<div class=\"f--field f--cta-title\">\n\n    \n  <h3>\n          <a href=\"https:\/\/dornsife.usc.edu\/news\/stories\/older-patients-willing-to-travel-longer-than-expected-for-health-care\/\" \n                        class=\"\" \n      >How far will seniors go for a doctor visit? 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investigate for the first time if DMV reporting mandates are associated with clinicians\u2019 likelihood of underdiagnosing dementia.<\/p>\n","protected":false},"author":13,"featured_media":19328,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[26,24],"tags":[257,162,60,95],"class_list":["post-19320","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","category-social-impact","tag-alzheimers-disease","tag-mental-health","tag-research","tag-social-sciences"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Laws requiring doctors to report a dementia diagnosis to the DMV may backfire<\/title>\n<meta name=\"description\" content=\"Laws requiring doctors to report dementia diagnoses to the DMV may cause some patients to go 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