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Driving Safe for Some With Alzheimer's

Frequent Monitoring Important, Experts Say
By
WebMD Health News
Reviewed by Louise Chang, MD

July 2, 2007 -- Many people in the early stages of dementia -- such as Alzheimer's -- can continue to drive safely as long as they are monitored closely.

That is the contention of a group of researchers in the United Kingdom, whose review of the clinical evidence led them to conclude that with frequent assessment of driving skills, the risk of accidents among older people with dementias was acceptably low for up to three years after diagnosis.

Geriatrician Desmond O'Neill, MD, who co-wrote the analysis, tells WebMD that mandatory screening of older drivers based on age alone is both unnecessary and ageist.

The analysis appears in the June 20 issue of BMJ, the British medical journal.

"Older drivers as a group are the safest drivers on the road," he says. "The very high-profile incidents involving older drivers have led to unwarranted prejudice against them."

Age, Autos, and Alzheimer's

The most high-profile case involved a 2003 crash in California at the Santa Monica farmers market. Ten people died and 45 others were injured when an 86-year-old man crashed through a barricade and drove for nearly two blocks before coming to a stop.

The driver, who had a valid license, later explained to police that he tried to stop the car but may have hit his gas pedal instead of his brakes.

Ironically, another Santa Monica incident, occurring seven years earlier, led to nationwide efforts to mandate license renewal testing for older drivers.

In November 1998, 15-year old Brandi Mitock was killed while crossing an intersection by a 96-year old driver with a history of dementia, strokes, and other health problems.

The man also had a valid driver's license but hadn't taken a road test since he had first gotten the license in 1918, according to news reports.

Several states require older drivers to renew their licenses in person, instead of by mail. Some states require elderly people to renew their licenses more often than other drivers or to pass vision tests when they renew them.

In the United Kingdom, drivers are required by law to inform motor vehicle licensing officials of a diagnosis of Alzheimer's or some other dementia.

This is not the case in most U.S. states, but a researcher who studies the issues faced by older drivers believes it is a good idea.

Knowing When to Give Up the Keys

Dennis McCarthy, PhD, is co-director of the National Older Driver Research and Training Center (NODRTC) at the University of Florida in Gainesville.

McCarthy says a "baseline" assessment administered by a specially trained driving instructor should be performed immediately following a diagnosis of Alzheimer's or other dementia, with similar assessments performed every six months after that.

"This way you know when a person's Alzheimer's disease has affected their driving, as it eventually will," he says. "But just because someone is diagnosed with Alzheimer's that doesn't mean they can't drive safely."

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