What leads older adults to cease driving? A recent study tracked older adults without any memory or cognitive issues to investigate this question. The study has been released in the online edition of Neurology®, the medical journal of the American Academy of Neurology, on May 22, 2024.
“Alzheimer’s disease progresses gradually–individuals may experience a 10- to 15-year timeframe without symptoms, but the disease continues to worsen over time,””We wanted to see if older adults showing early signs of Alzheimer’s would be more likely to stop driving,” explained Ganesh M. Babulal, PhD, OTD, of Washington University School of Medicine in St. Louis, Missouri. The study included 283 participants, aged 72 on average, who drove at least once a week. Cognitive tests were conducted at the beginning of the study and then annually for an average of 5.6 years. Participants also underwent brain scans and cerebrospinal fluid collection at the start of the study and then every two to three years. Throughout the study, 24 individuals stopped driving.When individuals ceased driving, 15 individuals passed away and 46 individuals experienced cognitive decline. Of those who stopped driving, nine had a neurological condition, four experienced significant changes in vision, eight had general health problems, and three relocated to assisted living. Among the entire group, approximately one-third met the criteria for preclinical Alzheimer’s based on biomarker levels for the disease, such as amyloid plaques and tau tangles, in brain imaging and cerebrospinal fluid. The study also revealed that female participants, those who developed cognitive impairment, and those with poorer performance on certain measures were more likely to have stopped driving.The study found that women were more likely than men to stop driving, as well as those who had no cognitive problems and performed better on cognitive tests. Interestingly, the presence of amyloid plaques and tau tangles in the brain and spinal fluid did not have any predictive value in determining if someone would stop driving. Out of all the participants, 58% of women stopped driving while only 42% of men did. Among those who developed cognitive impairment, 27% stopped driving compared to only 4% who did not develop cognitive impairment. Additionally, 30% of people with low cognitive test scores stopped driving compared to 7% of those with higher scores.Once the researchers accounted for various influencing factors, they discovered that female participants were four times as likely as male participants to cease driving. Individuals who met the criteria for cognitive impairment were 3.5 times more likely to stop driving compared to those with no cognitive issues. Those who scored lower on the cognitive tests had a 30% higher likelihood of stopping driving than those with higher scores.
“This study reinforces the recommendations of the American Academy of Neurology’s 2010 guideline regarding the progression to mild cognitive impairment based on the Clinical Dementia Rating.””Driving becomes riskier as people age and it’s important to counsel them about when they should stop driving,” explained Richard M. Dubinsky, MD, MPH, from the University of Kansas in Kansas City. He authored an editorial that went along with the study and was also one of the authors of the 2010 AAN guideline.
One limitation of the study was that the researchers did not have access to information about other medical conditions, any decline in vision or hearing, or the use of medications like antidepressants and sedatives, all of which are connected to the risk of failing a road test.
The National Institutes of Health, National Institute on Aging, and [INSERT MISSING TEXT HERE] supported the study.The Knight Alzheimer Disease Research Center at Washington University conducted a study on predicting driving cessation among older drivers who are cognitively normal.
