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 Not all patients with mild cognitive impairment, the early stage of
memory loss, have issues with driving, the researchers write in the
Journal of Alzheimer’s Disease.
However, patients with added impairments, such as difficulty with
multi-tasking or making quick decisions, are particularly likely to
have trouble with tasks like staying in lanes and making left turns
in traffic, the researchers write.
“Driving is a highly complex task that requires the integration of
multiple cognitive functions, such as attention, memory, and
visuospatial ability, all of which can be affected by mild cognitive
impairment,” said senior author Tom Schweizer, director of the
neuroscience research program at St. Michael’s Hospital in Toronto.
“Despite this, there are no validated tools or guidelines to help
assess the driving safety of patients with mild cognitive
impairment,” Schweizer told Reuters Health by email.
To study how mild cognitive impairment affects driving ability,
Schweizer and colleagues recruited 24 patients with memory loss.
They divided participants into two groups: one group with only
memory problems, and another group with other cognitive problems
too, such as issues with attention, reasoning/planning, or visual
perception.
Twenty cognitively healthy participants in the same age range acted
as a comparison group.
The participants underwent cognitive testing as well as a driving
simulation that tested their ability to perform a range of tasks
such as driving straight, making turns, and making left turns with
oncoming traffic.
Overall, patients with mild cognitive impairment committed more than
twice as many driving errors as the cognitively healthy drivers.
Memory impaired patients were more likely to cross the center line
of the road and stray out of the legal driving lane than healthy
drivers.
They were also more likely to make mistakes turning left with
oncoming traffic, but they had no issues with turning right, or
turning left with no traffic.
When researchers analyzed data on the two groups separately,
however, they found that seniors with only memory issues were not
more likely than healthy drivers to make errors.
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Patients with multiple cognitive impairments, however, were at much
greater risk of errors, including crossing the center line, missing
stop signs, and straying out of the driving lane. These individuals
were also much more likely to make errors during left turns.
A diagnosis of mild cognitive impairment alone “does not mean that
someone should stop driving, but it is important to monitor for
declines,” said Jennifer Davis, a clinical neuropsychologist at
Rhode Island Hospital who studies cognitive issues and driving.
Mild impairment is often a symptom of Alzheimer’s disease and is
likely to get worse over time, “so it is also important to help
patients and families identify when it might be time to stop
driving,” Davis, who was not involved in the study, noted by email.
“Families are encouraged to monitor driving by riding with their
family member as a passenger,” Davis advised, adding, “If concerns
arise, be sure to see your doctor and consider taking a formal road
test.”
“These results highlight the importance of physicians talking to
their patients about driving, even when cognitive deficits are very
mild in nature,” said Schweizer.
New tools are needed to help doctors better assess driving, he
added.
SOURCE: bit.ly/2j2aa28 Journal of Alzheimer’s Disease, online
December 9, 2016.
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