Young dementia patients at higher risk for hospitalization for vehicle crashes in Taiwan

Patients with young-onset dementia are at greater risk for hospitalization due to motor vehicle crash injury than those without dementia, according to a study published in JAMA Network Open.

“Studies have demonstrated that the deficits associated with dementia influence the ability to drive and safely navigate traffic,” Chih-Ching Liu, PhD, of the College of Medical and Health Science at Asia University in Taiwan, and colleagues wrote. “Nevertheless, many patients with dementia continue to drive cars or ride bicycles or motorcycles to maintain their independence and active participation in the community.”

As evidence connecting young-onset dementia with motor vehicle crash injury-related (MVCI) hospitalizations is lacking, Liu and fellow researchers sought to investigate whether an association exists by conducting a population-based cohort study, which drew participants from Taiwan’s National Health Insurance Research Database (NHIRD).

They included 39,344 patients, aged 40 to 64 years, who were diagnosed with dementia between 2006 and 2012 and matched them 1:1 by age, sex and index year to a cohort of participants without dementia. Hospitalizations for MVCI were determined by utilizing linked data from Taiwan’s Police-Reported Traffic Accident Registry and the NHIRD from Jan. 1, 2003, to Dec. 31, 2015. Investigators adjusted for sex, age, salary-based insurance premium, urbanization level and comorbidities when analyzing data.

During the 10-year follow-up, results showed the incidence density of MVCI-related hospitalization was 45.58 per 10,000 person-years (95% CI, 42.77-48.39) among those with dementia and 24.10 per 10,000 person-years (95% CI, 22.22-25.99) among participants without dementia.

Compared with participants without dementia, patients with young-onset dementia were at higher risk for MVCI-related hospitalization (adjusted HR = 1.83; 95% CI, 1.63-2.06), particularly those in the 40 to 44-year age group (aHR = 3.54; 95% CI, 2.48-5.07) and within a shorter period (within 1 year of follow-up: aHR = 3.53; 95% CI, 2.5-4.98) following a dementia diagnosis.

“These findings suggest a need for the planning of strategies to prevent transportation crashes among patients with young-onset dementia,” Liu and colleagues wrote.