Many Older Drivers Stay Behind the Wheel Despite Cognitive Impairments: Study

More than 60% of older Americans with cognitive impairments continue to drive, usually out of fear of losing their independence, researchers found.

Nearly two-thirds of older adults with serious cognitive impairments are still driving on U.S. roads and highways, creating potential auto accident risks, according to the findings of a new study.

Older adults suffering from Alzheimer’s disease or other signs of dementia are often reluctant to give up their keys and stop driving, as it is typically seen as a mode of independence. However, many of these individuals end up involved in car crashes, which may result in serious injuries for them or other motorists.

According to the findings of new research published in the Journal of the American Geriatrics Society, a majority of individuals with Alzheimer’s disease or other cognitive impairments continue to drive, despite major concerns among many of their primary caregivers.

Many Cognitively Impaired Drivers Still on the Road

Researchers from the University of Michigan Medical School conducted a cross-sectional analysis of the BASIC-Cognitive study in a community of 635 Mexican American and white participants in South Texas.

Participants were given the Montreal Cognitive Assessment (MOCA), and had an average score of 17. A score of 25 or less indicates the likelihood of cognitive impairment.

Overall, 61% of adults who scored below 25 on the MOCA were current drivers. Among those, 61% of Mexican Americans and 64% of white Americans continued to drive despite experiencing cognitive impairment.

“The majority of participants with cognitive impairment were currently driving,” the researchers wrote. “This is a cause for concern for many caregivers.”

The severity of impairment increased the likelihood an older adult was still driving. But that likelihood was only seen among white participants, and not among Mexican American patients who prefer to speak Spanish at home.

Among caregivers, 36% said they had concerns about their care recipient driving. Caregivers also had concerns about them driving at night, in the rain, or in heavy traffic and felt those situations may be too much to handle.

Despite concerns from caregivers, nearly two-thirds of older adults experiencing Alzheimer’s disease or Alzheimer’s disease-related dementias continued to drive.

Risks of Driving While Cognitively Impaired

People with Alzheimer’s disease lose the ability to drive safely as their disease progresses. But it can be difficult to share that message with the driver who hopes to continue to have their independence.

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Determining when an older adult with cognitive impairment should stop driving is complicated, researchers noted. Mild cognitive changes may not affect the ability to drive. But mild cognitive impairment can increase the risk of driving errors.

More so, loss of driving before an older adult suffers cognitive impairment can have a negative impact on well-being and lead to other problems.

The researchers determined that it is important not to wait for a car accident or other major driving incident before doing an assessment. Researchers recommend seeking out clinics with simulated driving evaluations to help determine if the adult’s ability to drive is impaired.

It can also be helpful to enlist the help of their doctor to assess their ability to drive and to have early conversations about when to stop driving, as well as when to begin to look for unsafe driving indicators. Similarly, turning to alternative transportation, like family members, friends, and ride-sharing, can help alleviate some of the pressure.


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