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Driving errors seen in early Alzheimer's
disease
September 13, 2004--Even
mild Alzheimer's disease may interfere with some seniors'
ability to follow basic driving instructions, according to study
findings released Monday.
In comparison to people without the Alzheimer's disease,
affected seniors were more likely to make incorrect turns, to
get lost and to steer erratically or make other such safety
errors, researchers report.
Alzheimer's disease currently affects one in ten Americans over
the age of 65, and nearly one out of every two individuals over
the age of 85. The condition is known to eventually impair
seniors' safe driving ability, but the mental deterioration is
gradual, so it may be difficult to recognize the point at which
people with Alzheimer's disease (AD) should stop driving.
"Currently, there are no firmly established criteria to predict
driver safety in Alzheimer's disease," said Dr. Ergun Y. Uc of
the University of Iowa.
"Our study is part of our project to scientifically address this
question," he added. "At this time, seniors with AD and their
families should discuss this issue openly with their physician,
undergo neuropsychologic and vision testing as needed, and
comply with retesting requirements with the DOTs of their
state."
To assess driving ability and safe driving practices, Uc and his
colleagues conducted a battery of mental and visual tests among
32 seniors with mild Alzheimer's disease and had them
participate in a route-following exercise.
For the 45-minute driving exercise, seniors used a mid-sized
station wagon equipped with hidden miniature cameras and other
sensors that monitored their control of the car's speed, their
driving lane, steering wheel position and other safety-related
information. For comparison the study also included 136 seniors
without any type of dementia.
The two groups were similarly able to maintain control of the
automobile, with regard to the position of the steering wheel,
number of lane changes and other aspects of basic vehicular
control, the report indicates.
Yet in the driving exercise, seniors with Alzheimer's disease
were more likely than those without the condition to turn too
quickly, too late, or in the wrong direction, to get lost and to
make safety errors, the majority of which included illegally
crossing lane boundaries, the researchers report in the
September 14 issue of Neurology.
"Even rather mild AD patients navigate poorly and commit safety
errors," Uc said.
Drivers familiar with the area in which the route-test was
taken, however, did not get lost. Also, the researchers note,
some drivers with Alzheimer's disease were able to follow the
driving instructions correctly and safely.
This suggests "that some individuals with mild dementia remain
fit drivers and should be allowed to continue to drive," the
authors write.
The driving errors were probably due to the increased demands
that the route exercise placed on the seniors' memory, attention
and perception, Uc and his team speculate.
In a related commentary, Dr. David A. Drachman of the University
of Massachusetts Medical School discussed the difficulty of
"assuring reasonably safe driving" among people with early
Alzheimer's disease.
He recommends that, if the patient's driving ability is deemed
safe by an experienced instructor, "a family member (should)
ride with the patient at least once a month, and if the observer
feels endangered, the driver should no longer operate a
vehicle."
Kathleen O'Brien of the Alzheimer's Association told Reuters
Health that she was not surprised with the study's findings,
that some seniors with Alzheimer's disease did not perform well
on the driving exercise.
In fact, she said, some people with Alzheimer's disease choose
to stop driving on their own, while some others have family
members who remove the car's distributor cap, file down their
car keys or use other "creative solutions" to deter their loved
one from getting behind the steering wheel.
O'Brien added that several chapters of the Alzheimer's
Association offer driving assessment clinics. To find out which
states are included and other information about Alzheimer's
disease, contact the Alzheimer's Association at 1-800-272-3900. |