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Getting older adults who are failing mentally to relinquish their car keys can be challenging. But those conversations are necessary, said researchers who found a majority of adults with cognitive impairment still get behind the wheel.
Michigan Medicine researchers studied this issue in a South Texas community. They found that more than 600 adults over age 65 in Nueces County had cognitive assessment scores -- scores of thinking and memory -- that indicated a likelihood of impairment.
Among them, more than 61% were current drivers. About one-third of their caregivers had concerns about the drivers' abilities to safely navigate the roads.
“It is likely appropriate that some with mild cognitive impairment are still driving, but for some it may not be,” said senior author Dr. Lewis Morgenstern, professor of neurology, neurosurgery and emergency medicine at University of Michigan Medical School.
“Patients and caregivers should discuss these issues with their health care providers and consider on-the-road driving evaluations to ensure safety,” Morgenstern said in a school news release.
About 1 in 9 Americans ages 65 and up lives with Alzheimer's disease. That's 6.7 million people. Millions more have related dementias.
These conditions can affect neuropsychological and visual skills that reduce the ability to drive safely, the researchers pointed out.
Dementia had medium to large effects on driving impairment, according to a 2017 review of motor vehicle crash risk. People with dementia also have an increased likelihood of failing a road test compared to those without.
The study authors found that the more cognitive impairment any individual had, the less likely they were to be driving. Also, many study participants limited their total amount of driving and avoided driving at night or in the rain.
Discussions between caregivers and people with declines in thinking about driving are difficult, the authors noted. Concerns include loss of autonomy, potential embarrassment and, perhaps, increased workload for the caregiver.
It's best to start these conversations early, while the care recipient is able to understand, the authors said.
“Close family may have discussions with aging loved ones about Advance Driving Directives," Morgenstern said. “These are agreements between an aging person and a loved one about having conversations about driving cessation."
The study results were published recently in the Journal of the American Geriatrics Society. This research was supported by the U.S. National Institutes of Health.
The U.S. Centers for Disease Control and Prevention has more on cognitive decline.
SOURCE: Michigan Medicine - University of Michigan, news release, July 20, 2023
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