Should Alzheimers Disease Patients Be Allowed to Drive? A Medical, Legal, and Ethical Dilemna

Abstract

This paper discusses the medical, legal, and ethical questions involved in permitting individuals with Alzheimer's disease (AD) to drive. Geriatricians must ask the following questions in this situation: does driving pose a risk to the patient with AD, will that person harm others when driving, and does enough evidence exist to limit an individual's freedom by taking away the driver's license? Overall, older drivers have fewer accidents and are good insurance risks. However, when the accident rate is expressed as crash rate/mile driven, the older driver is a very high risk. Growing consensus exists that any limitation placed on older drivers must be based on individual deficiency and not on age alone. The major risk factors for older drivers appear to be cognitive deficiency or neurological impairment. State laws vary as to how to limit the ability to drive of impaired people; an instrument to measure driving safety does not exist. Current data leads to a recommendation that those with mild to severe cognitive decline only drive with someone else "co-piloting" them; if AD is positively diagnosed, driving should be stopped.