More funding is needed to address the increasing problem of driving and dementia on Canadian roads, according to a new report published in the September 11 issue of the Canadian Medical Association Journal.
"Of all the activities of daily life that are affected by dementia, driving is potentially the deadliest," Dr. Mark Rapoport, a geriatric psychiatrist at Sunnybrook Health Sciences Centre in Toronto said in the report.
Dementia is the progressive decline in cognitive function that leads to a loss of mental ability impacting the normal activities of daily living.
Dementia, especially in cases that are not especially severe, can be dangerous in driving situations because it affects reaction time; the ability to solve problems; and the ability of someone behind the wheel to remember where they are going.
According to the report, the number of drivers suffering from dementia is increasing and is expected to rise as Canada's population ages.
The report recommends the best way to address the issue of driving and dementia is through road testing. But concerns are raised about how these tests are currently administered.
Currently, any cost for testing in Ontario is undertaken by patients themselves and can cost up to $500.
The report calls for more funding to provide available and affordable testing for dementia.
"The state of the art right now is an on-road driving test... we need to argue that it needs to be subsidized and made available for physicians to order so that patients can get assessed," Rapoport told CTV's Canada AM.
Other recommendations in the report include increased education for physicans to help detect signs of dementia. Often physicians can garner good information from family members of dementia patients. But information provided by patients is often 'poor' according to Rapoport.
Physicians currently have access to tests for dementia that assess visual and spatial skills as well as problem solving. But these tests have not been proven to determine whether a patient is a good driver or not. Consequently, patient analysis by neurologists can miss patients who fail the road test.
"Even despite all the skill and training that physicians have, we really need to see what (patients) are like on the road," Rapoport said.
The report also calls for legislation that addresses the issue of dementia clearly.
In most cases across the country mandatory reports must be filed by physicians when it is assessed that a patient should no longer drive. But Rapoport said existing legislation does not go far enough.
"Most of the legislation doesn't deal with dementia itself and some of the provinces have discretionary reporting," Rapoport said.
By 2028, the report estimates that there will be more than 98,000 drivers on the road with dementia in Ontario alone.
A 2004 report also co-authored by Rapoport published in the Canadian Alzheimer Disease Review cited the fact that dementia patients are two to eight times more likely than others of their age to be involved in a crash.
