Driving with dementia is a complicated and emotional issue for patients and their families. Alzheimer’s disease (AD) and other dementias result in the progressive impairment of thinking abilities necessary for safe driving, but there is much individual variability in how and when these disorders impact driving ability. Some individuals with mild dementia drive safely for a period of time, while others are unsafe to drive soon after the onset of memory loss symptoms.
Deciding when an individual with dementia must reduce or stop driving can be one of the most stressful issues faced by a patient and their family, who often struggle with the balance between personal independence and public safety. Driving allows individuals to stay engaged and connected to friends and family, enjoy an active lifestyle, and spontaneously meet their daily needs. Driving is not merely a means of transportation, but also a major aspect of overall independence, autonomy, and freedom. Driving cessation is considered by many to be one of the most significant and deeply personal losses they will face in advanced age.
Currently, there are no laws or policies in Massachusetts or in most other states that govern driving safety evaluation or driving cessation in the elderly, including those with dementia. A common recommendation for the older driver is to undergo a formal on-road driving evaluation. These evaluations are not readily available to many drivers, and they can cost several hundred dollars, an expense not covered by Medicare. Recognizing the significance of this issue, Dr. Robert Stern, Boston University Alzheimer’s Disease Center (BU ADC) Clinical Core Associate Director, was recently awarded a $240,000 grant from the Alzheimer’s Association to study driving safety in the elderly.
Dr. Stern’s project, the SAFE Drivers study, will examine 80 older drivers between 55 and 90 years of age. Participants will include cognitively healthy individuals, as well as individuals with mild cognitive impairment or dementia. The goal of the study is to evaluate a battery of existing office-based tests in order to determine which combination of tests most closely relates to real-world, on-the-road driving safety. Participants are asked to attend two appointments. During the first visit, participants are given office-based tests of attention, reaction time, problem-solving, memory, vision, and movement. The second appointment involves a free, on-the-road driving evaluation, which takes place in a Boston suburb and is conducted by a certified driving examiner. This study is an opportunity for older drivers to receive a formal on-road driving evaluation at no cost. Study results will lead to a brief, cost-effective, and highly valid alternative to formal on-road tests for evaluation of safe driving. This office-based alternative could eventually be used in doctor’s offices or at the Registry of Motor Vehicles. The alternative of a shorter, more cost-effective method may help drivers and their family members make better informed decisions about driving cessation. These informed decisions will lead to increased public safety and the maintenance of independence for those older adults with memory loss who are driving safely. For more information about the SAFE Drivers study, contact Linda Snyder (617-638-5619 or lmsnyder@bu.edu) or visit www.bu.edu/alzresearch/research/driving.
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