A
study in the July 2004 Canadian Journal of Psychiatry, led
by Dr. Robert Hopkins, estimates there are 34,000 Ontario drivers
who have dementia. With an aging driver population, it projects that
number will rise to nearly 100,000 by 2028.
The
researchers say that drivers in the earliest stage of dementia may
not be dangerous, but as their condition progresses they pose more
and more risk to themselves and other drivers. Drivers with dementia
are two to five times more likely to be involved in a collision
than drivers who do not have the condition. Collisions at intersections
are very common.
Over
the years, road fatalities have dropped significantly in all age
groups except 65 and over. Based on distance driven, older drivers
have more collisions than any other age group.
According
to the Canada Safety Council, dementia is one of several factors
that can affect the abilities of older drivers. When it comes to
collisions, data is lacking on how dementia stacks up against such
factors as: deterioration of eyesight, particularly at night; movement-limiting
disabilities such as arthritis and rheumatism; and medications,
which can affect driving ability in various ways.
“Seniors
who recognize age-related changes and learn how to compensate for
them can continue to drive safely for a long time,” says Canada
Safety Council president Emile Therien. “Unfortunately, the
onset of dementia is much harder to recognize than most other changes.”
Therien
notes older drivers tend to be safety conscious. Many choose to
drive shorter distances and avoid night driving, busy highways and
downtown areas. However, dementia affects memory, concentration
and judgement, and these are the very abilities that enable people
to deal with their own limitations.
He
agrees with Dr. Hopkins’s study that screening procedures
are needed to identify senior drivers who may have dementia, and
points out that such procedures are already being developed. University
of Ottawa researchers, including leading geriatricians from the
Faculty of Medicine announced in November 2003 a national multi-centre
five-year study called CanDRIVE in which 3,000 to 5,000 drivers
over the age of 70 are expected to participate.
Canadian
physicians are legally responsible in seven provinces for reporting
medically unfit drivers to their respective ministries of transportation.
The goal of the University of Ottawa study will be to develop a
method to help physicians identify seniors whose medical and functional
limitations may make them unfit to drive. Dr. Hopkins’s research
team suggested that such procedures should be added to the Ministry
of Transportation’s vision and road-sign tests.
So
the issue is being addressed — but in the meantime, what should
family members do when an aging parent suffers from dementia? If
they shouldn’t drive, how can Mom and Dad get around?
Family
members must take up the challenge of finding — or providing
— the necessary transportation. In the city, taxis and public
transit are cost effective (and less expensive overall than keeping
a car). Most suburban areas have these services, although access
may be less convenient. Rural areas offer few if any transportation
options; rides from friends and family are often the only alternative
to driving.
Regardless
of age, a driver’s licence means independence. In the interest
of safety, a ministry of transportation may decide to remove a person’s
licence due to a disability such as dementia. With the possibility
this will happen more often, society must be willing to provide
services to enable that individual to maintain a degree of independence.