When Should Dementia Patients Stop Driving?
American Academy of Neurology Offers Guidelines for Taking Away the Car Keys
Warning Signs of Driving Problems
The guidelines say these are some of the warning signs caregivers should
- Accidents. Research shows that people who have had a crash in the past five
years are more likely to have another accident, compared to people with
mild dementia alone.
- Moving violations. One study showed that people over 70 who had two or more
tickets in the past three years were more likely to have a crash than any other
age group, including teenage boys, who recently held that spot.
- Driving less. "The magic number seems to be 60 miles a week. Driving less
than that is associated with unsafe driving," although where you live and how
frequently you typically drive factor in, Iverson says.
- Avoiding certain driving situations, such as driving at night or in the
- Road rage. Research shows that aggressive or impulsive personality traits
can be useful in identifying unsafe drivers, Iverson says.
Becoming lost on a familiar route may also be a warning sign, says David
Knopman, MD, a spokesman for AAN who was not involved in writing the
Getting lost once may mean nothing, he says. "But if a person arrives two
hours late repeatedly with no good explanation or there are unexpected dents in
the car, there may a problem, says Knopman, a neurologist at the Mayo Clinic in
Caregivers and Doctors Take Charge
So is there anything a person with dementia can do to improve his or her
Not really, Iverson says. One study showed that people over 85 who took an
in-person test to renew their driving license slightly lowered their risk of
being in a deadly crash. But otherwise there was no evidence supporting
strategies such as driver training or licensing restrictions, Iverson says.
The bottom line, he says, is that even as dementia worsens, most patients
are going to deny that they pose a hazard on the road. That places doctors and
caregivers in charge.
Don't bring up giving up the car keys when a person is just recovering from
the blow of being diagnosed with dementia, Iverson says.
"But over time, caregivers and doctors should begin the discussion," he
says. "It's a process. And, it's not easy."
Doctors, patients, and caregivers must also know their state laws, because
some states require that doctors report any medical conditions that may affect
a patient's ability to drive safely.