Should a person with dementia drive

Dementia: how long can the patient drive a car?

People with manifest dementia are not allowed to drive. This also applies to patients with advanced Parkinson's disease. Nevertheless, a high percentage of people with dementia, especially older men, still drive a car, reports neurologist Professor Dr. Klaus Schmidtke in the journal “Advances in Neurology Psychiatry”.

The individual clarification of fitness to drive is difficult in the early and early stages of diseases of the central nervous system, writes the geriatrician, who heads the memory consultation at the Ortenau Clinic in Offenburg and a neurological rehabilitation clinic in Nordrach. Healthy people from the age of 75 needed more conscious attention and concentration in road traffic even under routine conditions and tired more quickly. It becomes problematic when disease-related cognitive deficits are added.

Most dementias, including Alzheimer's disease, are preceded by a phase of mild cognitive impairment known as "Mild Cognitive Impairment" (MCI). Especially the new memory is disturbed. Therefore, it is difficult for those affected to memorize new routes or the parking space for their car. Driving safety is usually sufficient at this early stage, writes Schmidtke. Since many MCI sufferers develop overt dementia within a few months to two years, the doctor should point out to patients and relatives at the MCI stage that the patient will probably soon no longer be fit to drive.

It is different with frontotemporal dementia (FTD), in which thinking, insight and judgment are limited at an early stage. Patients tend to have an aggressive and risk-taking driving style as well as impulsive actions. Therefore, the geriatrician advocates a consistent medical driving ban at the first signs of an FTD. Exception: If only the language is disturbed in the early stages, the fitness to drive may still exist temporarily.

People with early Parkinson's disease who are not mentally impaired and whose movement disorder is successfully treated are allowed to drive. Reduced mobility (hypokinesis), especially of the right leg, must be taken into account. As Parkinson's disease progresses, the ability to think and react deteriorates, so that those affected have to forego driving a car.

Relatives should address the problems as early as possible and explore alternatives for mobility, for example public transport, taxi or car pooling, recommends the German Alzheimer's Society in an information sheet. If the patients are not open to understanding, little tricks could help, for example parking the car out of sight. Some relatives would hide the key, disconnect the battery or pretend that the car needs to be repaired. It is important that giving up the car does not lead to social isolation and the abandonment of many activities, write the Alzheimer's experts. (bmg)

DOI: 10.1055 / s-0043-119988

You can also read about this: German Alzheimer's Society, information sheet No. 19, Driving and Dementia

02/06/2018 l PZ

Photo: Fotolia / curto