A media release on marketwire.com caught my eye, because elders and driving is a tough issue for many of us, let alone elders who are in the early stages of dementia. Also, many people without dementia take some of the drugs listed, namely antidepressants.
The release, titled "Road Safety and dementia patients on psychotropic medication," highlights research from the Institute of Clinical Evaluative Sciences (ICES), Ontario Ministries of Health and Transportation and Sunnybrook Health Sciences Centre.
Researchers found that patients prescribed psychotropic medication should be carefully evaluated for driving. "Patients on psychotropic medications - antipsychotics, benzodiazepines or antidepressants - were at a significantly greater risk of a motor vehicle collision (MVC) by approximately 50 percent," says Dr. Mark Rapoport, lead investigator of the study, psychiatrist at Sunnybrook Health Sciences Centre, and Assistant Professor in the Department of Psychiatry at University of Toronto."
The study "showed that antipsychotic medications were associated with the highest risk of a collision, benzodiazepines were associated with a modestly greater risk than placebo, and the risk with antidepressants was intermediate, with newer antidepressants paradoxically posing a higher risk than the older ones."
I find this study kind of scary, as I know many people - people without dementia - who are taking antidepressants. Many of them would be very unsafe drivers without the antidepressants. I'd hate to think of some overriding law, here or in Canada, where the study originated, taking over because some people on the medication may be bad drivers.
The same goes for someone newly diagnosed with dementia. Some of these people are beginning to experience some memory problems, so they go to their doctor for early detection, as is encouraged. They are put on drugs, many of which are not psychotropics. However, many are also put on antidepressants, as depression can go along with dementia (or, for some, be a result of the diagnosis).
However, we don't want people who are on drugs that make them unsafe drivers on the road. So, what to do? First, of course, there will need to be more studies. While this study pointed to the drugs and not the dementia as the cause of poor driving, another study may prove just the opposite. Until this is looked into thoroughly, people will need to depend on their common sense (or their loved one's common sense) and/or their doctor's orders.
Of course, this leads to the often asked question of how to get someone (anyone) who shouldn't be driving to quit. Driving is considered by many in our society to be a sign of independence, and few of us like the idea of giving up that privilege. However, driving is a privilege not a right.
I nearly always tell the person asking me about this issue that they will likely have to get a third party involved. Few people will listen to a spouse when it comes to driving cessation, and even fewer will listen to their adult children. Therefore, a doctor is often the perfect person to approach for help.
One of our local hospitals has a program where the elder (or any person being evaluated) is given a physical, mental and psychological workup, and then taken out in a car and observed driving under conditions that would seem normal to them. I live in an area that has some very busy metro-type driving going on. However, just a few miles out, or even on certain edges on the city, driving is pretty calm. So the personnel choose where to take the driver being tested, based on the type of traffic they would likely encounter in their routine driving. I realize this type of program isn't available to everyone, but it should be.
Your department of motor vehicles is another place to go for help. If you have doubts about someone's ability to drive, you could let the people at your DMV know before the person of interest goes for a license renewal. You may need a doctor to back you up, but perhaps they can help test the person to see if driving is wise.
Meanwhile, watching for further studies on these drugs to see if they back up the findings of this team of researchers is prudent. Also prudent, is watching the driving skills of anyone, with or without dementia, who takes any prescription drugs. Many drugs can make a person sleepy, slow reflexes or alter judgment, just as alcohol and non-prescription drugs can. Safety for the driver and those he or she may affect is far more important than convenience, pride or perceived independence.
Published On: October 20, 2008