Dementia and driving: Recognizing cognitive factors that prevent safe driving in older adults

Dementia can negatively impact a person’s life in numerous ways, including their driving ability. That is why it’s important to recognize cognitive factors that can prevent safe driving in older adults in order to reduce negative outcomes such as accidents.

Nearly half of drivers on the road today are over the age of 65, and that number is anticipated to reach 77 percent within the next 30 years. Adults over the age of 65 are at the highest risk for car accidents, compared to any other age group.

Driving requires many different skills and abilities, many of which are known to deteriorate with aging – for example, vision loss, hearing loss, reduction in motor skills, and loss of strength. Although many seniors recognize these changes and make the appropriate adjustments, those living with dementia often cannot detect and act on these changes on their own.

Not only does driving with dementia put the driver at risk, but it compromises public safety, too. First author of the study Lisa Kirk Wiese said, “It is important to note that it’s not a person’s chronological age itself that puts the older driver at increased risk for driving accidents, but rather the changes in functionality and skills needed for safe driving.”

Wiese continued, “Drivers with dementia and even their caregivers may lack the insight needed to limit and eventually discontinue driving. They might say something along the lines of ‘I have never had an accident,’ which is then confirmed by their loved one, and both are in denial that they could be an unsafe driver.”

The researchers suggests a three-pronged approach to assessing the drivers’ safety: patient assessment and medication review, a computerized simulation using a touch screen interface, and a road test with a certified instructor.

Wiese explained, “The task of identifying and helping older adults who are unaware of decline in cognition impacting road safety can be overwhelming for family members. Nurses who care for older adults in public health settings can play a vital role in understanding and identifying the cognitive mechanisms that inhibit effective driving and help to identify older adults who may be at risk for unsafe driving, and who would benefit from a driving evaluation.”

María Ordóñez, director of the Louis and Anne Green Memory and Wellness Center and an assistant professor in FAU’s College of Nursing, concluded, “Our driving evaluation program is one of several comprehensive services we provide to individuals with memory disorders and their families. We are committed to helping our clients function at their personal best to maximize their quality of life and to respond to their unique needs with caring, expertise, and compassion.”

Dementia and its effect on driving

One in every three dementia patients continues driving. A dementia diagnosis does not automatically translate into driving cessation. In order to continue driving, a person must have proper attention and concentration, visuospatial skills, problem-solving skills, judgment and decision-making, as well as reaction and processing skills. A safe driver must also remain calm and patient, and memory is required for many components of safe driving, such as remembering to switch your turn signal on or recalling the protocol for crossing all-way stop intersection.

With progressing dementia, many of these aspects begin to deteriorate, which can make driving more challenging and dangerous to both driver and public. Many dementia patients also have other medical conditions – such as vision or hearing loss – which can further complicate their driving.

If you (or someone you know) have been diagnosed with dementia, it’s important that you retest your driving capability and inform the licensing authority in your area of your diagnosis. Otherwise, you’re putting yourself at risk for prosecution, should an accident occur.