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    Dementia and Driving Don't Mix

    WebMD Health News

    June 26, 2000 -- Wes is 71 and has been driving a car for all of his adult life. His wife, Joyce, says that his most recent job was driving rental cars back to an agency at the airport in St. Louis. Walter, 83, a retired steel company executive, also loved to drive, especially around the suburban streets of Naperville, Ill., says his daughter Susan.

    In addition to a love of the open road, Wes and Walter share something else: Both men have dementia, and both have frightened their family and friends with their on-the-road escapades.

    According to the Alzheimer's Association, approximately 4 million people in the U.S. have Alzheimer's disease, and it is estimated that the number could increase to 14 million by 2050, making the prospect of sharing a lane with an Alzheimer's afflicted driver not such a remote possibility.

    The risk that these drivers pose to themselves and others is serious enough that the American Academy of Neurology is now telling physicians when to take away a patient's driving privileges. In the new guidelines, issued in the June 27 journal Neurology, the academy says that a person with Alzheimer's disease and moderate dementia has a "substantially increased accident rate" and should not drive.

    Neurologists consider a person with moderate dementia to be one who has some difficulty remembering recent events, such that the difficulty interferes with everyday activities. For example, this person might no longer be able to balance a checkbook or may stop a hobby such as woodworking. The person can take care of normal activities such as showering but may need some prompting to initiate the task.

    Richard M. Dubinsky, MD, tells WebMD that the AAN's quality standards subcommittee reviewed more than 200 published studies to develop the new guidelines. The evidence is clear: People with moderate or worse dementia "pose a significant traffic safety risk," says Dubinsky, who is lead author of the AAN guideline report.

    Dubinsky, an associate professor and vice-chair of the department of neurology at the Kansas University Medical Center in Kansas City, says that people with very mild dementia "are impaired but may continue to drive if they are closely monitored." He says that the guideline recommends that these patients have their driving skills evaluated every six months.

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