Mind & Mood
Subtle cognitive decline foreshadows older adults' end of driving
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- Reviewed by Toni Golen, MD, Editor in Chief, Harvard Women's Health Watch; Editorial Advisory Board Member, Harvard Health Publishing; Contributor
Among various factors that might foreshadow an older adult's decision to stop driving, cognitive changes are a more reliable signal than either age or biological signs of Alzheimer's disease.
The study, published online May 22, 2024, by Neurology, evaluated 283 people (average age 72) who drove at least once a week and had no sign of cognitive problems at the study's start. Participants underwent cognitive testing at the outset and then annually for an average of nearly six years. This included scoring on the Clinical Dementia Rating (CDR) scale as well as a test called the Preclinical Alzheimer Cognitive Composite, which is designed to detect subtle cognitive changes in people who score as unimpaired on the CDR. Participants also underwent brain scans and cerebrospinal fluid testing at the start and then every two to three years afterward, enabling researchers to look for molecular signs of Alzheimer's disease.
During the study, 24 people stopped driving, while 15 people died and 46 developed cognitive impairment (as measured by a CDR score greater than zero). Researchers found that both cognitive impairment as well as worsening of more subtle cognitive changes were linked to no longer driving. Interestingly, the presence of molecular signs of Alzheimer's disease was not associated with driving cessation. The findings suggest that cognitive testing that can detect the earliest levels of decline may help older adults and their doctors make decisions about driving that maximize safety and preserve independence as long as possible. This was a small study and further investigation is needed.
Image: © Mónica E. Vázquez Alvarez/Getty Images
About the Author
Maureen Salamon, Executive Editor, Harvard Women's Health Watch
About the Reviewer
Toni Golen, MD, Editor in Chief, Harvard Women's Health Watch; Editorial Advisory Board Member, Harvard Health Publishing; Contributor
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