Alzheimer's patients and driver's license: five minutes to understand the controversy

In a column published by Le Parisien almost a year ago to the day, six relatives of people with Alzheimer's recounted the isolation caused by the health crisis and called on the government to find solutions to improve their daily lives.

In this context, the decision of the Ministries of Health and the Interior on Sunday, to add Alzheimer's disease to the list of pathologies incompatible with driving, is obviously not welcomed by the associations which denounce a " total ignorance of the disease”.

At the origin of the project, the road safety delegation defends an order which is "the result of extensive consultation with doctors approved for medical fitness to drive".

What does the decree say?

The Ministries of Health and the Interior published a decree in the official journal on Sunday, updating the list - dating from 2005 - of pathologies incompatible with obtaining, renewing or maintaining a driving license.

Were added to dementia and psychosis, the "cognitive disorders of neuro-evolutionary pathologies such as Alzheimer's disease and related diseases".

“People with cognitive disorders linked to these pathologies should no longer drive as soon as a slight cognitive decline appears”, specifies the road safety delegation which carried out the project in a press release published on Sunday.

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A “total ax” for the France Alzheimer association.

"There are several degrees in cognitive decline," recalls its director general, Benoit Durand, who insists on the difference between a person who has just been diagnosed with Alzheimer's and another who has been sick for years.

"We could have imagined tests to determine the ability to drive the 1.2 million French people with Alzheimer's disease or related," he says again.

Not a total ban?

"It is not a question of prohibiting driving for people who have just been diagnosed with Alzheimer's", tempers one this Monday at Road Safety.

“This order actually has several scales: first, the treating doctor delivers his analysis but he can ask for the opinion of a certified doctor who himself can request cognitive tests”, specifies the organization which depends on the ministry. inside.

For Road Safety, this decree is a necessary update in order to prevent fatal accidents.

“Since 2005, people with dementia have been allowed to drive, which corresponds to stage 7 on the Reisberg scale

.

We simply lowered the incompatibility to driving at stage 3 of the disease,

 ,” it says.

“We regularly have cases of people with cognitive disorders who take the highway in the wrong direction,” also recalls the organization.

The question of the missing accompaniment

After two years of pandemic which have reinforced the isolation of people with Alzheimer's disease and their caregivers, the associations also deplore the absence of solutions to replace driving in the new decree.

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“A lady whose husband has a pathology called me this morning to tell me that he could no longer take his car to go to his speech therapist.

This lady works and cannot accompany her”, book for example Benoit Durand, while the car is often the last link between a patient and society.

"I don't know what to say anymore, for fear of being an outlaw," he adds.

Associations also fear that this decision will precipitate the cognitive decline of patients.

Asked about possible substitution measures or the aid that the State could provide to patients and their families, the Ministry of Health did not respond to our requests.

The timing of this measure is also pointed out, when the conclusions of a study on the problem of car driving were to appear in a few months, financed in part by the State and carried out jointly by France Alzheimer, Road Prevention and the Mederic Foundation.

On the side of the Ministry of the Interior, an order is put forward which "will facilitate the work of the approved doctors responsible for determining fitness to drive" and above all which allows people with hearing problems to get back behind the wheel, thanks to “new conductor equipment technologies”.