Mild Cognitive Impairment Alone Isn’t Enough Reason to Take Older Drivers Off the Road
When is it no longer safe for an older loved one to drive? This is a dilemma that families often face, and it can cause conflict, stress, and anxiety. Older drivers often connect driving with their sense of independence and dignity. A new study in the February issue of JAMDA offers some insights that may help families make decisions about when it’s appropriate to get someone off the road for their own safety and that of others.
In On-Road Behavior in Older Drivers with Mild Cognitive Impairment, the authors determined that while dementia increases the risk of unsafe driving, individuals with mild cognitive impairment (MCI) have on-road error profiles more consistent with cognitively normal (CN) older drivers. This suggests, they say, that recommending driver restrictions based on MCI status alone is unwarranted.
Study participants completed a health and driving history survey, a neuropsychological test battery, and an on-road driving assessment that included instructed and self-navigation components. Compared to safe CN drivers, safe MCI drivers showed similar error patterns. However, unsafe MCI drivers had greater levels of impairment in visuospatial, executive function, and attention than unsafe CN drivers. They also demonstrated more difficulties at intersections, roundabouts, parking, and driving on straight roads.
“We found no differences in the on-road driving errors of safe drivers with and without MCI,” the authors say, confirming previous findings that suggest driver restrictions based on MCI status alone may not be necessary. Instead, they offer, these drivers may require formal driving evaluation. They also observe, “Drivers with impairment across multiple domains, particularly visuospatial and executive, may need more tailored advice, support, and re-skilling on driving under cognitively demanding conditions.”
This study was conducted by researchers at School of Psychology, University of New South Wales, Randwick, NSW; Neuroscience Research Australia (NeuRA), Randwick, NSW; and School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia.
JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.
About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.