People with early Alzheimer's disease, though often very functional in many areas of life, may not be as competent behind the wheel of a car as those without the memory-damaging disease.
"Our research indicates that even among people who have early, mild cases of cognitive decline, there is an immediate drop-off in driving skills," says study author Jeffrey Dawson, an associate professor of biostatistics at the University of Iowa in Iowa City.
Dawson and other researchers from the University of Iowa evaluated the driving abilities of 40 older people diagnosed with early Alzheimer's disease and 115 elderly drivers without the condition. Study participants first had a series of off-road tests that measured thinking, movement and visual skills.
They then moved to a road test in which everyone drove the same Ford Taurus station wagon. The scientists hooked up four small in-car video cameras to monitor pedal reactions, eye and head movement, and expressions of the driver as he or she traveled along a 35-mile route that included city and non-city roads. A researcher rode along for safety reasons.
The authors tallied 76 different driving errors, including incorrect stops and failure to stay in the proper lane. Their research, published in this week's Neurology, reports that drivers with Alzheimer's disease made an average of 42 safety mistakes, while non-Alzheimer's drivers made 33 road errors -- or 21% fewer slip-ups.
The most common gaffes were lane violations, Dawson says. "We saw about a 50% increase in crossing-the-line errors in Alzheimer's patients," he says, noting that all of the participants still had their driver's licenses.
Dawson says he hopes the research will lead to development of potential interventions and alerting devices for the cars of Alzheimer's patients.
Most states do not require doctors to report newly diagnosed Alzheimer's patients to the department of motor vehicles.
For the most part, families, caregivers and patients themselves determine whether they should be driving, says Maria Carrillo, director of medical and scientific relations for the Alzheimer's Association. "We're not for the blanket removal of driving rights for people with Alzheimer's disease, since many people with early Alzheimer's may still be safe drivers," she says. "It's a very emotional issue to take away the keys, to take away the independence."
Carrillo says Alzheimer's patients can rely on GPS systems if a caregiver helps program the devices. She suggests family members who suspect a loved one has a dementia-related driving problem talk with the person and a family doctor about their concerns. They also can consult a driver rehabilitation specialist who can assess road skills. To find one, visit the website of the American Occupational Therapy Association: aota.org/olderdriver. Or call a hospital or rehabilitation facility to ask for advice or an evaluation from an occupational therapist with training in driving skills.
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