The “Co‐pilot” Driver Syndrome

T here is a great deal of uncertainty surrounding the optimal time for a patient with Alzheimer's Disease to cease driving.l'" Two-thirds of the states in United States have specific regulations regarding impaired drivers/-Io but many of those policies are vague, imprecise, and can be interpreted in several ways. 1 Ironically, states often have policies that are diametrically opposed to one another in regard to Department of Motor Vehicle (DMV) notification of patients with Alzheimer's Disease with impaired driving ability. Eight states have no policy respecting when a patient with neurological impairment such as Alzheimer's disease must be reported.1 In New York State, patients may sue a physician who notifies the DMV about possible poor driving performance (physician! patient confidentiality). In California, it may be considered malpractice not to notify the Department of Motor Vehicles about a patient with a possible diagnosis of Alzheimer's disease, irres~ective of the patient's stage of disease or functional status. ,11 We have observed that many Alzheimer's disease patients continue to drive with reasonably safe driving records. In an effort to better understand this observation, we interviewed many of our patients and their caregivers. We present our findings in four cases of patients with mild to moderately severe Alzheimer's disease as we look at their struggle to drive and their desire to stay independent in the community. We report this condition as a "co-pilot" driver syndrome that is likely to be much more common than currently realized.