Driving is a difficult subject to broach after a dementia diagnosis. While driving represents independence to older adults, dementia affects almost every skill guiding a vehicle requires: vision, judgment, reaction time and the ability to multitask. Caregivers often struggle to decide on the right time for their loved one to stop driving, both for their loved one’s safety and the safety of other drivers. But it’s a necessary conversation: A new study shows that in-person license renewal dramatically reduces hospitalizations of drivers with dementia, suggesting the best way to stop dementia patients from driving is by requiring a driving and vision test.
The study compared in-person testing to mandatory laws in the three states—California, Oregon and Pennsylvania—that require physicians to report dementia patients to the Department of Motor Vehicles. They found that there was no observable benefit to having doctors report their patients.
“This was surprising, as we know that older drivers stop driving based on the advice of their physicians and, if reported to licensing authorities, few regain driving privileges,” said lead author Yll Agimi, a health data scientist at Salient CGRT Inc. “That leads us to conclude that other licensing requirements may act as the principal means of identifying at-risk older drivers, before physicians identify and report a patient with a medical impairment, such as dementia.”
There are only five states that do not require drivers to show up in order to get a license renewal at least once every two to three cycles. Two states require an actual driving test at time of renewal, and 36 states require vision testing.
When the researchers analyzed crash data from older drivers, they found that those who did get in a crash were less likely to have dementia in states that had in-person requirements and vision requirements. However, physician reporting laws didn’t seem to effect getting drivers with dementia off the road.
“The results of our study point to age-based licensing requirements as an effective way to improve safety,” said co-author Steven M. Albert, professor of public health at University of Pittsburgh. “But such requirements also may cause social isolation and depression, and may be seen as ageist and discriminatory. So it is very important that our findings spur further study to determine the best approach to ensure safe driving for all on the road while avoiding a negative impact on the mental health of older adults.”
This study was published on January 31, 2018 in the journal Neurology.