Driving Safe for Some With Alzheimer’s

As long as they’re closely monitored, many people with early stages of dementia (such as Alzheimer’s) can drive safely.

This is the belief of a group in the United Kingdom of researchers who reviewed the clinical evidence and concluded that the risk of accidents for older people with dementia was acceptable up to three years after their diagnosis. Desmond O’Neill MD, a Geriatrician, said that mandatory screening older drivers solely based on their age is both unneeded and ageist. This analysis is in the June 20 issue BMJ, a British medical journal. He says that older drivers are the most safe drivers on the roads as a whole. “Unwarranted prejudice has been built against older drivers because of the high-profile incidents that involved them.”

Age, Autos and Alzheimer’s

One of the most notable cases involved a crash at Santa Monica Farmers Market in 2003. An 86-year old man drove nearly two blocks and crashed through a barricade, causing the deaths of 10 people and injuring 45 others. Later, the driver, who was a licensed driver, explained to police that he attempted to stop his car, but may have used his gas pedal rather than his brakes. Ironically, a similar incident in Santa Monica seven years ago led to national efforts to require license renewal testing for older drivers. Brandi Mitock, 15, was struck and killed by a 96 year old driver while crossing an intersection. He had a history of strokes, dementia, and other health issues. According to news reports, the man had a valid driver’s license and hadn’t taken a road exam since 1918 when he first got it.

Many states require that older drivers renew their licenses in person rather than by mail. Some states require that elderly drivers renew their licenses more frequently than others or pass vision tests. Drivers in the United Kingdom are required to notify motor vehicle licensing officials of any diagnosis of Alzheimer’s disease or other dementia. Although this is not true in all states, a researcher who examines the problems faced by older drivers thinks it is a good idea.

Know when to give up the keys

Dennis McCarthy, PhD is the co-director of National Older Driver Research and Training Center at the University of Florida, Gainesville. McCarthy recommends that a “baseline” assessment be done by a trained driving instructor immediately after a diagnosis of Alzheimer’s or another dementia. Similar assessments should be made every six months thereafter.

He says, “This will let you know if someone’s Alzheimer’s has affected their driving as it eventually will.” “But, just because someone has Alzheimer’s doesn’t mean that they can’t drive safely. McCarthy is a similar opinion to O’Neill. Despite highly publicized statistics to the contrary, McCarthy believes older drivers are the most safe drivers on the roads. Although he acknowledges that older drivers are more likely to be involved in accidents per mile driven than other age groups, he believes the statistics are misleading.

A 40-year-old may drive 15,000 miles per year on the turnpike. Older people tend to drive fewer miles total and mostly on streets that are statistically more hazardous. He says that older drivers tend to be more cautious and less likely to do wrong. He says that they might not drive at night, or only when there is traffic light. They tend to stay near home. He also stated that mandatory, age-based testing for older drivers is not a cost-effective or effective way to identify those who should not be driving.

He says, “We haven’t developed very good clinical tests to predict driving performance and doctors don’t always know how to determine if a patient should drive or not.”

McCarthy states that older Americans in America need better transportation to be independent after they retire from driving. According to NODRTC, there are 19 million drivers older than 70 years in the United States. By 2024, one in four drivers will have reached 65. McCarthy states that there are acceptable alternatives to driving in order for an older person losing their license not to be so devastating.

Updated 01/24/22