When is it time to give up the keys?

The Packet (Clarenville) - - Editorial - BY RICHARD RUS­SELL WHEELS

De­men­tia is the loss of cog­ni­tive func­tion due to changes in the brain caused by dis­ease or trauma.

Cog­ni­tive func­tions in­clude think­ing, spa­tial ori­en­ta­tion, de­ci­sion-mak­ing and judg­ment — all pretty sig­nif­i­cant when it comes to driv­ing.

Med­i­cal ex­perts tell us de­men­tia can also re­sult in be­havoural and per­son­al­ity changes, de­pend­ing on the por­tion of the brain af­fected.

These changes can come grad­u­ally or quickly and how they oc­cur may de­ter­mine whether the de­men­tia can be treated or is ir­re­versible.

Mil­lions of peo­ple suf­fer from se­vere de­men­tia and mil­lions of others have mild to mod­er­ate cases.

It is es­ti­mated that five to eight per cent of peo­ple over the age of 65 have some form of the ll­ness and that num­ber dou­bles ev­ery five years from that age.

As is the case with many health is­sues, the knowl­edge and in­ci­dence of de­men­tia have both in­creased in re­cent years.

There is some de­bate about whether that is the re­sult of mproved di­ag­nos­tics, greater aware­ness or be­cause in­creased ongevity is cre­at­ing a larger pool of el­derly folks where the dis­ease is com­mon. The great­est risk fac­tor for de­men­tia is ad­vanced age.

That leads to the whole is­sue of el­derly driv­ers and the re­quire­ment for a stan­dard­ized method of test­ing or screen­ing to de­tect de­men­tia and other dis­eases. It is not as sim­ple as a road test.

The med­i­cal com­mu­nity says in-ve­hi­cle tests may not de­tect health-re­lated prob­lems be­cause the early warn­ing signs are of­ten very sub­tle.

The is­sue is that of dis­tin­guish­ing be­tween driv­ers who are el­derly and el­derly driv­ers with a med­i­cal prob­lem that af­fects their abil­ity to drive. It has be­come easy fod­der to pick on el­derly driv­ers be­cause of a few news­wor­thy events cre­ated by them. But at the other end of the scale we also have new young driv­ers caus­ing spec­tac­u­lar in­ci­dents.

Young driver in­ci­dents are most of­ten re­lated to ex­ces­sive speed for con­di­tions and in­ex­pe­ri­ence. With the el­derly, the prob­lem is loss of at­ten­tion and even loss of mo­bil­ity or con­scious­ness.

In the early stages of de­men­tia, driv­ers may re­tain the skills nec­es­sary for the safe op­er­a­tion of a mo­tor ve­hi­cle. But, in most cases, de­men­tia is pro­gres­sive and driv­ing skills can de­te­ri­o­rate sig­nif­i­cantly in a short pe­riod of time.

The Alzheimer So­ci­ety of Canada says some in­di­vid­u­als may be ca­pa­ble of driv­ing safely for some time af­ter a di­ag­no­sis “de­pend­ing on when in the dis­ease pro­gres­sion the per­son has been di­ag­nosed and the rate the dis­ease pro­gresses.” Even­tu­ally, it says, peo­ple with Alzheimer’s dis­ease must stop driv­ing, as it will no longer be safe.

Alzheimer’s dis­ease is the most com­mon cause of de­men­tia. The symp­toms of de­men­tia in­clude mem­ory loss, visual-spa­tial dis­ori­en­ta­tion, and de­creased cog­ni­tive func­tion. Visual-spa­tial dis­ori­en­ta­tion as it re­lates to driv­ing can be de­scribed as the in­abil­ity to prop­erly co-or­di­nate where you are with the mo­tion of traf­fic around you.

Cog­ni­tive func­tion is the men­tal pro­cesses that al­low us to carry out a task. These in­clude re­ceiv­ing, re­mem­ber­ing and pro­cess­ing in­for­ma­tion.

The pro­gres­sion of de­men­tia varies from one in­di­vid­ual to an­other mak­ing it dif­fi­cult to know when or how to limit or stop driv­ing.

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