The elderly driver: dementia and road safety

Dementia, and particularly Alzheimer’s disease, increases with aging, and, in fact, 10% of the population over 65 years of age suffers Alzheimer’s disease, which amounts to 32-47% in the population older than 85 years; this segment shows the highest risk when driving. These drivers have five times more traffic accidents than healthy elderly.

Symptoms interfering with driving

Progressive cognitive impairment initially occurs as slowly progressing loss of memory, affecting mainly fixation memory, and later affecting distant recall.

Furthermore, these patients suffer behavior and neuropsychological disorders, where psychical impairment starts with isolated speech disorders including progressive aphasia, or only with visual and space disturbances. Then the disorder becomes generalized to comprehensive cognitive impairment.

The initial loss memory loss can persist relatively unapparent for over a decade. The early diagnosis is usually difficult and many of the cases of dementia get unnoticed to physicians.

Personality is well preserved at the beginning; however, depression is frequent and reaches nearly 20% of the patients.

Mild parkinsonism, gait disturbances, and some motor manifestations can also appear in these first moments, which indicates the huge difficulties for driving a car.

In any case, the progressive loss of cognitive control of the patient together with the psychomotor impairment prevents from fulfilling driving skills and, therefore, results in a greater susceptibility in case of traffic accidents.

The visual function of the driver with Alzheimer, with difficulty in reading, in recognition of shapes and colors, in visual and spatial orientation, and in perception of the movement explains the risks of driving and the insecurity as pedestrian.

Problems

The possibility that elderly people with dementia continue driving is a growing concern. In fact, half of the patients with dementia have had at least one accident before they stop driving. Mild dementia in the elderly people allows for living an apparently normal social and family life, though interfering seriously with the ability to drive cars.