One would ordinarily consider the most difficult decision to be the one about the birds and the bees with your kids. Not true-not if you have a parent with serious cognitive decline. It is really about the car.
At this time, 20 percent of drivers aged 80 or older who are applying for license renewals have some level of cognitive impairment. There are no screens for this at renewal. Compounding the issue is worsening vision. States vary in the amount of intact vision required to legally drive. While the US. Government suggests 100 percent of the visual field to be intact, states like Kentucky require only 20 percent. Shocking. It translates into an inability to seeing cars in neighboring lanes and even children low-down on tricycles.
In defense of states with lower visual requirements for driving, or even for cognitive impairment, patients simply will avoid screening/treatment for either. So, in the end the roads will be no safer and fewer diagnoses will be made early on, affecting treatment outcome. Further, neurologists tell patients with early cognitive decline to preserve their cognitive functions by staying engaged in social activities and exercise, which of course may become impossible if their keys are taken away.
Some may argue that younger drivers (especially male) are more likely to get into fatal crashes. Studies suggest that that is due to the ongoing creation of connections within the frontal lobe through the age of 29. The frontal lobe is involved in judgment and inhibition. However, the same data shows that the rate of crashes then continues to decline until the age of 70, when it again begins to spike. The worsened crash record in the elderly is due to impairment in information processing speed, motor reaction time, and vision. In fact, in Kansas, one out of every five crashes involves at least one driver older than 65 years old. This is a burgeoning issue: there are currently almost 29 million drivers over age 70 nationwide, expected to grow to almost 57 million by 2030.
The red flags of concern for family members and caregivers are reports of getting lost in familiar place, running red lights or traffic signs, slow reaction time to a potential hazard ahead, poorer judgment of distance, and, funny enough, reports from your kids they don’t want to get in the car with grandma. The neurodegenerative diseases most commonly associated with these driving issues, are Alzheimer’s disease, Frontotemporal dementia, Parkinson’s Disease, and Lewy body disease.
It is imperative to have a loved one tested for cognitive impairment if one is suspected and their driving assessed. For the driving, it is most advisable to take them for a road test. There are online websites that have databases of driving specialists. If your loved one fails, it’s probably best not to confront head on, but, rather, to hide the keys, sell the car or claim the car is still in the shop. If it’s not time to take away the keys, most cars these days have driving assist, enhanced warning signals of lane switches, parking assist and voice direction for where to go and to alert of harm.
BeCare Neuro Link can help. This app can detect the earliest signs of cognitive impairment (including those affecting driving) and follow for worsening over time. Further the app assesses vision. BeCare Neuro app can help you determine when its time to bring in outside help to save the lives of your loved ones and strangers when they get behind the wheel.
https://www.vumedi.com/video/navigating-the-driving-discussion-in-dementia/