Even small changes in cognitive function can impact an elderly person’s choice to cease driving, as indicated by a recent study. The results propose that regular cognitive assessments, especially those intended to identify the earliest, most subtle declines, may assist older adults and their doctors in making driving-related decisions that prioritize safety and uphold independence for as long as feasible.
One of the most difficult decisions for elderly individuals is knowing when to relinquish their keys and cease driving. A recent study conducted by researchers at Washington University School of Medicine in St. Louis may offer guidance in this matter. rnrnThe study revealed that cognitive decline is a significant factor in seniors’ decisions to stop driving, more so than their age or the presence of Alzheimer’s disease markers. Even minor cognitive changes can indicate that retirement from driving is on the horizon. Additionally, the study found that women are more likely than men to cease driving.
These results indicate that regular cognitive testing, especially the kind that detects the earliest and most subtle declines, could assist older adults and their doctors in making informed decisions about driving to optimize safety while planning for the future.The study, which is published in Neurology, emphasizes the importance of discussing age-related changes with older drivers. According to corresponding author Ganesh M. Babulal, PhD, OTD, it is crucial for doctors to identify any potential risks early so that they can support the remaining driving capacity and skills of their older patients. This can help extend the time that they can drive safely and allow for a smooth transition to alternative transportation options when the time comes to stop driving. Older drivers should be aware of the changes that come with aging, including subjective cognitive decline, and take proactive steps to maintain their independence for as long as possible.The medical journal of the American Academy of Neurology.
According to the American Academy of Neurology, older adults above the age of 65 are the most cautious when it comes to driving. They are less inclined to speed, drive in hazardous weather conditions, drive at night, or drive under the influence of substances compared to drivers in other age groups. However, despite these efforts, age-related changes such as slower reaction time, impaired vision, and cognitive decline still pose a risk to older drivers, making them more susceptible to crashes. Furthermore, in the event of a crash, older drivers are more likely to suffer severe injuries or fatalities compared to younger drivers. On the other hand, giving up driving also comes with its own set of risks. Studies show that individuals who stop driving are more likely to face certain challenges.The 2010 study by the American Academy of Neurology found that cognitive impairment, as measured by the Clinical Dementia Rating (CDR) scale, was a strong indicator of when to stop driving. The CDR scale, ranging from zero to three, assesses cognitive function, with a score above zero being a predictor of stopping driving. However, the CDR scale may not detect impairments until they significantly impact daily life, and research has shown that cognitive decline can occur for years before it is reflected in the CDR score. Babulal and colleagues also found that older adults who stop driving may be at higher risk of developing depression and becoming socially isolated.Researchers wanted to understand the impact of various factors, such as subtle cognitive changes, on the decision to stop driving. They observed 283 individuals, with an average age of 72, who drove at least once a week and showed no signs of cognitive impairment at the beginning of the study. Their main focus was to determine the timing and reasons behind each participant’s decision to cease driving.
Participants underwent cognitive assessments at the beginning of the study and then annually for an average of 5.6 years. The cognitive tests involved the CDR and a preclinical Alzheimer’s cognitive composite (PACC) score, specifically designed for early detection.The study aimed to identify subtle cognitive changes in individuals who were deemed unimpaired based on the CDR. Participants also underwent brain scans and provided cerebrospinal fluid at the beginning of the study and then at regular intervals, allowing researchers to search for molecular indicators of Alzheimer’s disease. At the start, approximately one-third of the participants met the criteria for preclinical Alzheimer’s disease based on levels of biomarkers in the brain and cerebrospinal fluid, such as amyloid plaques and tau tangles.
Throughout the study, 24 individuals ceased driving, 15 passed away, and 46 developed cognitive impairment as indicated by changes in their CDR score.The study found that several factors were predictors of individuals stopping driving, including cognitive impairment, declining PACC scores, and being female. Those who met the criteria for cognitive impairment by scoring 0.5 or greater on the CDR were 3.5 times more likely to stop driving compared to those who scored zero. Additionally, individuals with lower PACC scores were 30% more likely to stop driving than those with higher scores. Interestingly, age and the presence of Alzheimer’s disease biomarkers did not impact the decision to stop driving. The study also revealed that gender had the biggest effect, with women being four times more likely than men to stop driving.ly to stop driving during the course of the study than men were.”We know from past studies that there isn’t a difference in driving ability between men and women,” Babulal said. “What we have shown in prior work is that women are often more aware of their abilities, are more willing to admit that they are no longer able to safely drive, and plan more in advance to transition out of driving compared to their male counterparts. It is highly recommended that older male drivers talk with their providers about driving and consider stopping driving earlier.”Doctors do not routinely counsel older patients on driving cessation, a factBabulal believes that there is a missed opportunity to promote healthy aging. He states, “There are things we can do to help people adapt to age-related changes.” Babulal suggests that driver rehabilitation programs, led by occupational therapists, can offer specialized training and strategies for older drivers to adjust to physical and cognitive changes in order to maintain their driving capacity. He also mentions that community support programs provide a platform for older adults to share experiences and learn about safe driving practices and alternative transportation options. Babulal emphasizes the importance of starting the conversation early, as ultimately, most people will need to stop driving.Improved support for the independence and quality of life of older adults is crucial. The reference for this article is as follows:
