With more older adults on the road and dementia cases rising, some states require doctors or patients to report dementia diagnoses to the Department of Motor Vehicles (DMV). However, a new study suggests that mandated reporting policies may inadvertently lead to clinicians missing or delaying dementia diagnoses and patients reluctant to seek medical help for memory issues.
The potential disconnect between reports to the DMV, which is then responsible for assessing a person’s driving fitness, and timely dementia diagnoses affects 18 states. Some four states (CA, DE, OR, PA) require clinicians to report a dementia diagnosis to the DMV and 14 states (AL, HI, IN, MO, MT, NE, NM, NY, ND, OH, SC, UT, VA, WA) mandate that drivers self-report a dementia diagnosis. The remaining 32 states and the District of Columbia have no explicit requirements.
The study emphasizes that future research is needed to understand unintended consequences and risk-benefit tradeoffs of these required reporting policies.
Here are five key study takeaways:
1. Primary care physicians required to report all patients with dementia diagnoses were 59% more likely to underdiagnose dementia compared to states without such requirements.
2. The likelihood of underdiagnosing dementia was 12.4% for doctors in states with mandatory reporting laws, versus 7.7% in states with no reporting rules.
3. Patients may be reluctant to disclose memory issues or get assessed if they know a dementia diagnosis could lead to losing their driver’s license.
4. Doctors face a tricky balance; they could face penalties for not reporting a diagnosis that leads to an accident, but pushing reluctant patients to investigate memory challenges could damage the doctor-patient relationship.
5. With little evidence that mandatory reporting significantly improves road safety, the potential benefits may not outweigh the risk of missed or delayed diagnoses.The study notes that there is a “lack of clear evidence for positive associations of clinician reporting mandates with road safety,” and therefore “it remains challenging to determine whether the benefits outweigh the risk that our study uncovered.”
