Driving and dementia

How does dementia affect driving?

A diagnosis of dementia is not in itself a reason to stop driving. One in three people with dementia still drives. The most important thing is whether the person can still drive safely. Dementia may affect their ability to do this. 

Driving may feel easy and natural for people who drive often or have been driving for many years. However, it is a complex task that involves quick thinking as well as sensory (vision, hearing) and manual skills.

A safe driver must use a range of mental abilities including:

• focus and attention – to switch between different driving tasks while 'reading’ the road
• visuospatial skills – to keep the right speed, distance and road position
• problem-solving skills – to deal with any challenges on the road, such diversions or obstacles
• judgement and decision-making – for example, to understand and prepare for the actions of other road users
• reaction skills – to act quickly to avoid an accident
• memory – for example, to remember a route.

Being patient and calm also helps people to drive more safely.

As dementia gets worse, it affects these skills even more. This means everyone with dementia will eventually be unable to drive safely. How quickly this happens varies from person to person.

Most drivers with Alzheimer’s disease will need to stop driving in the middle stage of dementia. Some types of dementia have certain early symptoms that mean an end to driving might be sooner. For example, visual hallucinations are common in dementia with Lewy bodies and impulsive behaviour is common in frontotemporal dementia.

Other health conditions that affect driving

Many people with dementia have other health conditions that may also affect their driving.

Problems with vision and hearing are common in older people, as is arthritis. If this affects a person’s neck, it may reduce their head-turning ability. This can make manoeuvres like pulling out into moving traffic much harder. 

Some older people also have weaker muscles which can make physical tasks like steering or braking difficult.

Certain medications may also affect a person’s driving – such as drugs taken to help a person to sleep or some drugs for depression. If the person needs to inform their driver licensing agency about taking these medications, the doctor will advise them of this.