Navigating the decision to relinquish driving privileges poses a significant challenge for older adults. Recent research from Washington University School of Medicine in St. Louis sheds light on this complex issue, suggesting that cognitive decline, rather than age or Alzheimer’s disease markers, often signals the time to stop driving. The study underscores that even minor cognitive changes can indicate impending retirement from driving, with women more likely than men to make this decision.
Published in Neurology, the study advocates for regular cognitive assessments tailored to detect subtle declines early on. These assessments, crucial for informed decision-making, could help older adults and their physicians enhance safety while preserving independence. According to Ganesh M. Babulal, PhD, OTD, the study’s lead author, proactive discussions about cognitive changes are essential. Early identification of risks allows for interventions that support driving skills and facilitate a smoother transition to alternative transportation options when necessary.
Despite older adults over 65 being among the most cautious drivers, age-related factors such as slower reactions, impaired vision, and cognitive decline increase their crash risk. Moreover, older drivers are more likely to suffer severe consequences when accidents occur than younger counterparts. However, ceasing to drive isn’t without its challenges—those who stop driving face higher risks of depression and isolation.
The research, which lasted over 5.6 years and involved 283 participants initially free of cognitive impairments, monitored changes through cognitive tests, including the Clinical Dementia Rating (CDR) and the Preclinical Alzheimer’s Cognitive Composite (PACC) score. Surprisingly, neither age nor Alzheimer’s biomarkers strongly influenced the decision to stop driving. Instead, cognitive impairment and declining PACC scores emerged as key predictors, highlighting the importance of monitoring subtle cognitive changes.
Gender also played a significant role, with women showing a higher likelihood of stopping driving during the study period compared to men. This finding challenges stereotypes about driving abilities between genders and underscores the proactive approach women often take in acknowledging changes in their driving skills.
Dr Babulal emphasises the need for healthcare providers to initiate conversations about driving cessation early on. He advocates for tailored interventions, such as driver rehabilitation programmes led by occupational therapists, which equip older drivers with strategies to adapt to physical and cognitive changes. Community support programmes also play a crucial role in educating older adults about safe driving practices and alternative transport options.
While most older adults eventually need to stop driving, the study underscores the benefits of proactive planning and support in maintaining independence and quality of life. By integrating routine cognitive assessments and fostering open discussions, healthcare providers can be pivotal in ensuring older adults navigate this transition confidently and safely.
More information: Ganesh M. Babulal et al, Predicting Driving Cessation Among Cognitively Normal Older Drivers, Neurology. DOI: 10.1212/WNL.0000000000209426
Journal information: Neurology Provided by Washington University School of Medicine
