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Docs Issue Guidelines for Drivers With Dementia
Date:4/12/2010

shows drivers with dementia are at a much higher risk of accidents.

Taken together, the research suggests that some people with dementia can still drive reasonably safely, at least at the outset of the disease, Iverson said.

"Patients with mild dementia are at higher risk as a group for unsafe driving. But a lot of them, if not most of them, are safe drivers when put on the road," Iverson said. "The alarmist group would say that nobody with dementia should be driving. The apologist groups says, wait a minute, as many as 76 percent [of people] with dementia who take the test still pass. It's probably too categorical a statement to say nobody with dementia should be driving."

The guidelines were published in the April 12 online issue of Neurology and were to be presented Monday at the American Academy of Neurology's annual meeting, in Toronto.

Among the other warning signs: a history of crashes; traffic citations; reductions in miles driven; avoiding driving at night, in the rain or other situations; showing aggressive or impulsive personality traits; and scoring low on the Mini-Mental State Examination, another test of thinking skills used to detect impairment.

With driving so important for independence and quality of life, the decision to stop driving is never easy, said Dr. David Knopman, a professor of neurology at the Mayo Clinic in Rochester, Minn.

In addition to memory loss, Alzheimer's causes problems with geographic orientation, slowed reaction times and slowed mental processing, all of which are necessary for safe driving.

"People with dementia are more likely to be uncertain where they are going and more likely to hesitate in intersections or abruptly change directions -- behaviors that would put them at greater risk of having accidents," Knopman said.

Because of changes in the brain caused by Alzheimer's, the patient may be unaware there's a problem, Knopman said. Lapses
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