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Background: driving is an increasingly important form of transport for older people. Dementia is common in later life and will eventually lead to driving cessation, which reduces the public health risk of impaired driving but also impairs access to services. The factors associated with driving cessation in dementia are uncertain. Objective: to examine the demographic, psychometric and personal factors associated with driving cessation in patients attending a memory clinic in a European setting. Design, subjects and setting: a retrospective study of 430 consecutive patients referred over a 21 month period to the memory clinic at a university teaching hospital. Methods: the data collected included a questionnaire administered to their carers regarding demographic and personal factors as well as driving practices. All subjects had standardised neuropsychological and functional assessments. Dementia diagnosis was recorded using DSM IV criteria. Results: driving cessation in this population was associated with poorer cognitive and functional status, older age, and living in the city. Of those studied, 22% continued to drive: 63% of these were driving daily, 71% were driving unaccompanied and 31% reported an accident. There was no difference in the neuropsychological testing between those who reported an accident and those who did not report an accident. Conclusions: driving cessation was affected not only by psychometric performance but also by demographic and personal factors. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to evaluate the effect of introducing a European Society of Cardiology guideline-based Integrated Care Plan (ICP) for Syncope on hospital admissions and referral patterns to an outpatient Syncope Management Unit, of patients presenting to an Emergency Department (ED) with a syncopal episode and to determine the underlying causes of syncope., Methods and Results: This study is a single-centre observational case series of consecutive adult patients presenting to the ED over a 5-month period. Two hundred and fourteen of 18 898 patients (1.1%) had a syncopal episode, 110 (51.4%) of whom were admitted. Forty-six (41.8%) admissions were indicated by the ICP. All potential cardiac syncope cases were admitted. There was a 500% increase in the overall number of referrals to the Syncope Management Unit with a small increase in the number of unnecessary referrals., Conclusion: The introduction of an ICP for syncope was not associated with any cases with potential adverse outcomes being lost to follow-up and resulted in increased referral rates to the syncope unit. However, hospitalization rates for syncope remain high, and a large number of patients requiring early outpatient assessment were not referred. There remains a need to develop further interventions to guide appropriate and safe syncope management in the ED.