CogniFit's Science blog: Alzheimer's And Driving - When Is It Time To Quit?

Alzheimer's And Driving - When Is It Time To Quit?

One of the hardest decisions for any older person to make is when is it time to stop driving? Driving represents more than just a means of transportation, it is a way of life, a part of society and perhaps most important, the key to maintaining independence. Many different health issues can cause a person to give up driving, for their own safety as well as for the safety of others on the road.

But what happens when a person is diagnosed with early Alzheimer's?. The person can still function and still needs to be independent and still needs to drive. There may be few outward signs of the disease, but then again, just because there are no outward signs, doesn't mean that person is fit to be behind the wheel.

About 600,000 elderly adults stop driving for some health reasons every year, according to the National Institute on Aging. But there are about 2 million people with early Alzheimer's and it is predicted that the numbers will skyrocket in the next few years.

Scientists are trying to develop tests to determine when a person should stop driving. Driving is one of the most complex activities in our lives. It involves many, many cognitive skills, all being needed at the same time and working together in harmony.

Jeffrey Dawson, a biostatistics professor at the University of Iowa has been doing research on driving and early Alzheimer's. Dawson and his team have developed a rather complex driving test with a lipstick-sized video in the car to show oncoming traffic and other devices that will record every action the driver takes on a 35 mile drive through rural, residential and urban streets.

40 drivers with early stage Alzheimer's who were still driving took the road test and their results were compared to 115 older drivers without dementia who took the same route. The results are notable.

Alzheimer's drivers committed 42 safety mistakes as compared to 33 for the other drivers. Alzheimer's drivers were 50% worse at lane violations, such as swerving or hugging the center line as another car approaches. For every 5 years of age, 2 1/2 more mistakes were made, regardless of whether the driver had Alzheimer's or not- age does make a difference in driving.

There was some good news though. Some Alzheimer's patients drove just as well as their healthier counterparts. The question is of course why? And how can we predict who will be able to drive and who should be off the road?

Failing memory tests did not make any difference in driving skills, however those drivers who did poorly on multitasking abilities tests (ones that showed if cognitive, visual and motor skills are working together to help make quick decisions) were a very good indicator of a person's driving ability.

Alzheimer patients who scored average or better on multitasking tests were no worse behind the wheel than other older drivers. But those Alzheimer's patients who scored lower than average usually committed about 50% more errors on the road.

More research is needed, but it seems that testing multitasking abilities could be the basis for a simple doctor's office exam to help patients and their families determine when it's time to give up the keys and how to find ways to help the ex-driver compensate for this loss of independence.