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Dementia Underdiagnosis and Driver's License Laws - TIME   

It’s uncomfortable to talk about older adults and driving, a fact that many families who’ve worried about a loved one’s dwindling eyesight, reaction time, or cognition behind the wheel are well aware of. The ability to drive isn’t a right, but in many parts of the U.S. it’s become a necessity, the only way to access the world outside the home. When an older adult’s freedom threatens their safety, who gets to make the choice to take a car or license away?

For a long time, the answer has been an unsure combination of the U.S. government, physicians, and family members. But as the population of Americans older than 65 grows at a faster rate than any other age bracket, seniors’ presence on the road is growing as well. According to the Federal Highway Administration (FHA), there were 48 million licensed drivers ages 65 and older in 2020, nearly 70% more than there were two decades before. Data from the FHA show that seniors account for 20% of drivers on U.S. roads, where the types of impairments frequently associated with aging incur a greater risk of crash involvement. 

Policies meant to ensure drivers remain capable as they age—such as stricter vision-testing for license renewals and reporting requirements for dementia diagnoses—exist, but according to new research presented in late October at the 2023 Clinical Trials on Alzheimer's Disease conference, they may be undermining—or at least complicating—their intended outcomes. For example, some states require that drivers (or their doctors) notify the Department of Motor Vehicles if they get diagnosed with certain conditions that are impossible to evaluate at DMV facilities, like diabetes, seizure disorders, and most importantly, dementia.

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