Can I Drive With Dementia?

• The simple answer is NO!

• People with dementia have a much higher crash risk then non-dementia drivers.

• The routine driving test for elderly drivers doesn’t identify the impaired older driver with dementia.

• Yes a person with dementia can can still steer the car but their crash risk is very high. They can still “drive” with embedded procedural memory from doing the same thing for many years.

• The routine driving test does not include a cognitive driving test for seniors.

• Cognitive functions essential for safe driving are impaired even in early Alzheimer’s dementia including-

• ·       Speed of thinking/information processing.

  ·       Reaction time/reflexes.

  ·       Left/right orientation.

  ·       Geographic orientation.

  ·       Impulsivity and control of their emotions and reflexes.

  ·       Visual vigilance/concentration.

  ·       Not being easily distracted.

  ·       Managing dual simultaneous stimuli.

  ·       Sustained selective attention.

  ·       Divided attention.

  ·       Rapidly switching attention.

  ·       Responding to multiple visual stimuli simultaneously.

• Drivers with dementia, despite having low average annual mileage, do pose a significant increased risks to occupants of other vehicles, and pose the most serious risks to themselves and their passengers of fatal and non-fatal crashes.

• Most families are very protective of their elderly mother or father with dementia and insist that they can still drive locally despite significant dementia.

• Driving is very much a cognitive brain activity not a physical activity.

• The older driver’s accident risk also tends to increase with increasing age.

• Those impaired drivers 80 years and over have fatal crash risks similar to teenage drivers, the highest risk group of drivers.

• In terms of older drivers, the testing of motor coordination and muscle speed, cognitive and mental functions, and visual porcessing speed and perception becomes especially important (in addition to vision and reflex testing) but is just NOT done.

• Over the same driving distance, drivers with dementia are 5 times more likely to be involved in a fatal accident than the younger driver (25-64 age) and the older driver has a much higher probability of being fatally injured when involved in a crash.

• Drivers with dementia who are involved in car crashes are much more likely to be the cause of the crash compared to younger drivers.

• Drivers with dementia have impaired ability to judge the velocity and distance of approaching vehicles. They are also typically involved in accidents in which they fail to give way to the right, make dangerous turns and ignore traffic signals.

• Compared with normal people of similar ages, people with Alzheimer's disease or other forms of dementia have a much higher risk of accidents and episodes of getting lost while driving.

• Driver's general menta1 status and 'useful field of view' (UFOV] are strongly associated with crash risk.

• The driver with dementia has impaired ability to rapidly detect, process and localise visual information, divide visual attention across central and peripheral locations and detect the relevant visual targets within multiple visual stimuli (UFOV) . Cognitively impaired older drivers just cannot process information rapidly.

• UFOV size decreases in dementia most likely due to decreases in brain visual processing speed, reduced visual perception, and increased distractibility when driving.

  For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.