WASHINGTON, April 7, 2009
Early Alzheimer's Increases Driving Hazard
Study: More Mistakes Made Behind The Wheel Among Those With Early Signs Of Disease
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(CBS/AP)
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Interactive Losing Memories Facts about Alzheimer's, help for caregivers and a look at sufferers who've put the disease in the spotlight.
It's one of a family's most wrenching decisions, and as Alzheimer's increasingly is diagnosed in its earliest stages, it can be hard to tell when a loved one is poised to become a danger.
Factor in that much of the country lacks public transportation, and quitting too soon restricts independence for someone who otherwise may function well for several years.
"That's a real cost to the individual and family and society," says Jeffrey Dawson of the University of Iowa. "You have to have some sort of trade-off between the individual's independence along with the safety of the driver and with other people on the road."
Typically, specialists say, patients gradually scale back their driving, avoiding busy freeways or night trips or left-turn intersections. Alzheimer's Association adviser Sue Pinder, 58, recently gave up big-city driving even though it meant fewer visits to a daughter in Dallas.
Shortly after Pinder's diagnosis in 2004, she signed a form designating her husband to decide when she'll quit driving altogether. He gave her a GPS system for her last birthday. It helped Pinder navigate unfamiliar streets when, to be near another daughter, the couple recently moved to West Monroe, La., from a nearby town.
"That's helped a lot where I don't have to worry, I can concentrate on my driving and not the directions," Pinder says.
Working on ways to help similar patients, Dawson's team in Iowa developed an intricate behind-the-wheel exam: A 35-mile drive through rural, residential and urban streets in a tricked-out Ford Taurus able to record just about every action the driver takes, much like an airplane "black box" does. Lipstick-size video cameras were positioned to show oncoming traffic, too.
Researchers recruited 40 people with early-stage Alzheimer's who still had their driver's licenses to take the road test, and compared how 115 older drivers without dementia handled the same trip.
The results, reported in the journal Neurology, are striking. On average, the Alzheimer's drivers committed 42 safety mistakes, compared with 33 for the other drivers.
Lane violations, such as swerving or hugging the center line as another car approaches, were the biggest problem for the Alzheimer's drivers. They performed 50 percent worse.
Overall errors rose with increasing age whether or not the driver had Alzheimer's, an extra 2½ mistakes for every five years of age.
But some Alzheimer's patients drove just as well as their healthier counterparts, stresses Dawson, a biostatistics professor. Here's the key: Researchers also checked whether any of a battery of neuropsychological tests given beforehand accurately predicted who would drive worse - and some did.
Flunking simple memory tests didn't make a difference. Standard neurologic tests of multitasking abilities did, ones that assess if people's cognitive, visual and motor skills work together in a way to make quick decisions. Examples include showing patients geometric figures for a few seconds and having them draw the shape from memory, or drawing paths between a sequence of numbers and letters.
Alzheimer's patients who scored average or better on those types of written tests were likewise no worse behind the wheel than other older drivers - but those who scored worse than average tended to commit about 50 percent more errors on the road, Dawson says.
More research is needed but the ultimate goal is an easy doctor's-office exam to help guide when patients should give up the keys.
About 600,000 elderly adults stop driving for some health reason every year, according to the National Institute on Aging. But there's little clear guidance for the roughly 2 million people estimated to be in Alzheimer's early stages, and the disease is poised to skyrocket in two decades as the population grays.
States have varying laws on when aging drivers must pass a road test for a license renewal, but they seldom address specific diseases; California requires reporting of Alzheimer's diagnoses so driving can be assessed. The Alzheimer's Association tells families warning signs of unsafe driving.
But as Alzheimer's worsens, patients often vehemently deny that they're a hazard, says Dr. Gary Kennedy, geriatric psychiatry chief at New York's Montefiore Medical Center.
"I can be the bad guy," he tells families, sometimes reporting patients to the Department of Motor Vehicles for a driving test or advising relatives to disable the car.
"Giving up the car is not like going into the nursing home," Kennedy counsels patients, trying to recruit relatives or friends to schedule rides. "If as a society we recognize this as a danger, we need to help them compensate."
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- They compared two groups the older drivers and the early-stage Alzheimer patients but they don´t mention the ages of the Alzheimer patients. It´s important to know it because there are people under fifty with Alzheimer diagnosis.
We conclude that we can´t measure the driving hazard of a person whether with the age or any diagnosis they´d have. This dementia bring down some cognitive abilities such as memory, learning, speaking and spatial vision yet not all of these happen in the same person or in the same time.
That´s why older people or any person with dementia must check-up their neuropsychological skills periodically otherwise, it would be an injustice to take away driving licenses to every aged people or Alzheimer patients. - Reply to this comment
- that is interesting about signing something that allows others to take your keys from you at a certain stage. I wish everyone would do something like that.
Yes, very difficult to make an elderly give up driving sometimes.
There are many bad drivers, not just the elderly. When I am driving, you better believe I drive defensively. If I see an elderly or a teenager or someone sitting really low behind the steering wheel, I keep my distance from them and watch them to do something erratic. To be sure, you cannot be vigilant all the time and someone may ram right into you regardless of how defensively you are driving. However if we all paid more attention to the OTHER drivers (and note their age and how they are driving), I am sure many accidents could be avoided (stay off your cel phone, you ARE DISTRACTED when you are using it, you cannot convince me otherwise).
But again, many accidents simply cannot be avoided.
Stay safe.
And when you get older and iffy (or not older but still iffy) remember to GIVE UP THOSE KEYS. - Reply to this comment
- First, everyone over 55 should have vision tests at least every 3 years. I have met people who kept driving when they could not see 30 feet. They could not recognize some standing on the other side of a room.
I knew 2 different people who were legally blind but still driving.
Then there was a charming couple: he was legally blind, but his wife did the navigating, telling him where to turn. None of them had Alzheimer's, they were just determined to stay independent.
Now, what are the excuses for the young drivers and the addled politicians? - Reply to this comment
- Please give us laws to remove the addled politicians!
I believe that all states should make driver retesting mandatory after certain ages, probably around 70, although I am acquainted with a few people over 80 who are still competent drivers and some 55 year olds who are terrible drivers.
Now, what about the younger drivers, any age, who are complete and total idiots. I have a nephew, around 25, who has totaled 3 vehicles, been jailed twice over driving while (pick any or all) intoxicated, license suspended, and/or without auto insurance.
The problem seems to be keeping fools of any age of the road. (And addled politicians)
Oh yes--I kept telling everyone I knew that Reagan had Alzheimer's long before the press finally admitted it. He actually showed symptoms. - Reply to this comment
- Just don't try to tell an 80 year old that they have problems or need to get off the road. My father in law is 84 has lost his vision to one eye but he has memorized all the things he needs to do to retain his license. On his own part he has limited himself to day time driving and only in his small home town. There are however elderly drivers here in a larger city who cruise through red lights, weave through lanes etc. I have tried reporting one of them but the police but they can't really do anything 'unless' there has been an accident. I hope I will be able to stop driving when my time comes & I do understand what the elderly are going through.
- Reply to this comment
- Government Study shows Alzheimers affects driving. These jackasses probably spent $50 million to prove the patently obvious!
Reminds me of another government study to determine when geese fly in their "V" formation, why one side of the "V' is always longer than the other.
After 2 years and $100 million dollars, scientists discovered the answer.....
More geese on one side! - Reply to this comment
- Maybe, just maybe, if the government and FDA would stop poisoning our food, water and especially all these synthetic drugs this disease would drop to a low percentage of our people instead of rising. Posted by Baileyccc
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- "42 safety mistakes, compared with 33 for the other drivers"... What is not new news in this article, and it should be, is that 33 mistakes were made by elderly drivers. We had the wretching job of taking away keys from an elderly family member over his strong objections. He didn't have Alzheimer's but he was 85 years old and a danger to everyone on the road. He didn't want to give up his independence but for YEARS we knew he was as much a danger on the road as any drunk driver. THIS JOB SHOULD NOT BE LEFT TO FAMILIES. The state giveth the license the state should taketh it away. Do you know impossible it is to take someone's driving privileges away when you have no authority to do so? It tore our family apart. Everyone over the age of 65 or 70 should be drive tested yearly but that isn't going to happen because they (we) are a huge political force. So people are going to die unnecessarily. Society needs to start protecting itself from those who think they are still capable but aren't. It is about to get worse as we baby boomers hit our mid 60's.
grandma in georgia - Reply to this comment
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