Drivers With Dementia and Outcomes of Becoming Lost While Driving

Abstract

Researchers of driving and dementia have reported that drivers with early Alzheimer's disease (AD) may continue to drive for extended periods of time, as long as their driving is evaluated or monitored. The earliest symptoms of AD are known to include loss of recent memory and the inability to recognize familiar environments. In an exploratory study, we examined 207 reports of lost drivers with dementia over 10 yr reported by newspapers and media. Seventy AD drivers were not found, 32 drivers were found dead, and 116 drivers were found alive, although of those found alive, 35 people were found injured. Miles driven and days missing were also reported in some cases, in addition to cause of death (such as drowning or exposure to weather). Becoming lost may have serious consequences. Additional research is needed in this area to more clearly understand the consequences of becoming lost while driving.

Evaluating Driving as a Valued Instrumental Activity of Daily Living

“…Adults with dementia are at an increased risk for unsafe driving and crashes (Fox, Bowden, Bashford, & Smith, 1997), and studies have shown that people with dementia often become lost when driving (Rowe, Feinglass, & Wiss, 2004;Silverstein, Flaherty, & Tobin, 2002). Evidence supports elevating our response to warning signs of cognitive impairment: The consequences of getting lost for people with dementia have been shown to include injury or death (Hunt, Brown, & Gilman, 2010).…”

The Effect of the Global Positioning System on the Driving Performance of People with Mild Alzheimer's Disease

“…If the information from the navigator is given correctly, and in a timely and orderly way, drivers are not required to recall route-finding information; rather, they are able to focus on driving [17]. Nonetheless, Hunt et al [9] discouraged reliance on this strategy as navigators with poor navigational skills have been found to be a hazard because they can increase the drivers' cognitive load if misinformation is provided.…”

“…The potential consequences of drivers with AD becoming lost cannot be ignored; therefore, it is essential that potential solutions to help drivers with way-finding difficulties are explored in research [9,17]. Approximately 10-40% of drivers with mild AD have been reported as relying on their spouse or passengers to give them verbal prompts for navigation [15,17].…”

“…At an international conference on road safety, clinicians and researchers agreed that the licences of drivers diagnosed with moderate to severe AD should unconditionally be revoked because of the increased risk of their involvement in traffic accidents [8]. Although the driving ability of people in the early stages of AD may be substandard compared with their age-matched controls [6,9], they have also been observed to drive safely [10] and to pass on-road driving assessments [3]. Therefore, a positive diagnosis of AD alone is inadequate justification for the termination of one's driving licence [11].…”

“…Current road tests for licensing are not sensitive enough to identify individuals with way-finding difficulty, as the assessor will give directions for the drivers to follow [15]. Nonetheless, some of the initial symptoms of AD, such as attention deficit, loss of memory and deterioration in topographic and spatial orientation, are known to significantly affect navigation abilities [9]. The literature shows that drivers under pressure to find a destination are at a higher risk of making mistakes, which might threaten not only their own safety, but also that of the public [16].…”