• Posted May 24, 2024

Subtle Mental Declines Occur Before Older Folk Quit Driving

One of the toughest decisions seniors face is when to give up their keys and stop driving.

Even slight changes to the ability to remember, think and reason can lead a senior to decide to stop driving, a new study finds.

Impaired cognitive function foreshadows the decision of many seniors to give up driving, even more so than age or physical changes related to Alzheimer's disease, researchers found.

And routine brain testing -- in particular, screening meant to detect the earliest and most subtle decline -- could help older adults make safe driving decisions while still preserving their independence, the study concluded.

“Many older drivers are aware of changes occurring as they age, including subjective cognitive decline,” said researcher Ganesh Babulal, an associate professor of neurology at Washington University School of Medicine in St. Louis.

“Doctors should discuss such changes with their older patients,” Babulal added in a university news release. “If risk is identified early, there is more time to support the remaining capacity and skills, extending the time they can drive safely, and to plan for a transition to alternative transportation options to maintain their independence when the time comes to stop driving.”

For the study, researchers tracked 283 people with an average age of 72 who drove at least once a week and had no cognitive impairments at the start.

The participants underwent brain testing every year for an average of nearly six years, researchers said.

They also received brain scans and provided cerebrospinal fluid every two to three years, to look for early signs of Alzheimer's disease.

From the start, about a third of the people met the criteria for Alzheimer's disease without any symptoms, based on abnormal amyloid and tau proteins found in their brains and spinal fluid.

During the study, 24 participants stopped driving, 15 died and 46 people developed cognitive impairment, researchers said.

Three factors predicted who would stop driving during the study, researchers found -- symptoms of cognitive impairment, worsening screening scores for Alzheimer's and being a woman.

Women were four times more likely to stop driving than men during the course of the study, results show.

The study was published May 22 in the journal Neurology.

“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.”

Men should be encouraged to be realistic about their capabilities as they age, Babulal said.

“It is highly recommended that older male drivers talk with their providers about driving and consider stopping driving earlier,” Babulal said.

And doctors should consider routinely counseling older patients about driving, which Babulal sees as an opportunity to promote healthy aging.

“There are things we can do to help people adapt to age-related changes,” Babulal said.

“Driver rehabilitation programs, often led by occupational therapists, can provide specialized training and strategies for older drivers to adjust to physical and cognitive changes to maintain driving capacity,” Babulal noted. “Community support programs provide a forum for older adults to share experiences and learn from each other about safe driving practices and alternative transportation options.”

“Ultimately, most people will need to stop driving, but by starting the conversation early, we can better support older adults' independence and quality of life,” Babulal said.

More information

The National Institute on Aging has more about safe driving for seniors.

SOURCE: Washington University School of Medicine, news release, May 22, 2024