A majority of older adults with cognitive impairment are still driving, despite concerns raised by caregivers and others, a Michigan Medicine study in a South Texas community has found. The researchers assessed more than 600 adults over age 65 years old who had cognitive assessment scores that indicated a likelihood of impairment.

Of those with cognitive impairment, 61.4% were current drivers, and around one-third of all caregivers had concerns about their care-recipient driving.

“It is likely appropriate that some with mild cognitive impairment are still driving, but for some it may not be,” said senior author Lewis B. Morgenstern, MD, professor of neurology, neurosurgery and emergency medicine at the University of Michigan Medical School.

The authors write, "Dementia affects neuropsychological and visual skills, reducing driving safety. In a study that examined driving with dementia, participants who failed a driving exam scored more poorly on items regarding their ability to follow instructions, make correct and quick decisions, interpret traffic signs, stay in their driving lane, make a complete stop, and understand how their driving was affecting others.

"A review of motor vehicle crash risk for driving with dementia found medium to large effects of driving impairment and an increased likelihood to fail a road test compared to healthy controls. For those experiencing cognitive impairment, these processes could be dangerous."

The researchers acknowledge that discussions between caregivers and people with cognitive impairment about driving are difficult, with concerns over the loss of autonomy and potential embarrassment. When a person with cognitive impairment stops driving, that may also increase the workload of a caregiver.

They suggest it’s best to start conversations surrounding driving earlier while the care recipient is able to understand and actively participate in the discussion.

To read the study, published in the Journal of the American Geriatrics Society, click here