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Driving a car to move around has become a requirement nowadays, particularly for those living in rural areas or in areas where public transport is not so efficient. However, many concerns regarding the possibility and the safety for the elderly to drive a car are often brought up.

 

We know that “going out”, keeping engaged, and socializing are all very positive activities that can prevent cognitive decline, or slow down its progression. But it is also known that often with old age come also slower reflexes and worsening eye-sight and hearing. What should be done in such cases, and who is to decide whether an older person should be allowed or not to drive a car? And what is usually done when somebody gets diagnosed with dementia but usually drives?

 

Since the 1990s the concept of traffic medicine has evolved quite a bit, focusing on preserving mobility, with physicians becoming increasingly important in making sure that their patients are able to drive for as long as possible, while still keeping public safety in mind.

 

While the public perception of older drivers is generally negative, data and research seems to point in another direction:

 

  • in general driving skills seem to improve with age;
  • drivers older then 80 consistently show more prudent driving behaviours;
  • even the presence of medical conditions is associated to a just a very modest increase in driving accidents;

 

When it comes to elderly living with dementia, the data is different, and the risk of a crash is significantly increased. However, patients are in general capable of driving relatively risk-free for up to three years after the onset of dementia.

 

It appears clear how important the role of the physician is in making sure to inform newly diagnosed patients about the risks associated with driving, and inquire about their driving capabilities and habits.

 

Legally speaking, there is no common set of practice, with some countries requiring the physician to report to the competent driving authority about a new dementia cases, while other countries leave it to the new patient to self-report.

 

It is very important to find a balance between public safety and the necessity for the person living with dementia to remain mentally active and engage in activities outside of his home environment.

 

source: Breen, D.A., et al. (2007), Driving and Dementia, BMJ, 334(7608), pp. 1365-1369