認知症と自動車運転〈総説〉

Drivers with Dementing Illness

はじめに

　現代社会において，自動車は便利な移動手段であるだけにとどまらず，生活の質を向上させる手段として欠かせないものである．近年，高齢の運転者数が急増しており，65歳以上の運転免許保有者は1000万人を超えている^1）．そのことから，認知症患者の自動車運転免許保有数は免許保有者数と認知症の有病率から，約30万人に上ると考えられる中，2002年に道路交通法が改正され^2），その第103条で「公安委員会は認知症患者の運転免許証を停止，あるいは取り消すことができる」とされた．しかし認知症の中にも症状・程度が様々あり，どのような基準で「認知症患者」を判定し，どういった評価で運転中止を決定するかといった具体的な指針は法律にも示されておらず，また医療現場でも認知症患者の運転中止の判断基準は存在していない^3，4）．

Abstract : The number of drivers with dementing illnesses is rapidly growing, and this issue has been neglected for too long in Japan. We evaluated the present state of drivers with dementia and analyzed their driving behavior. Our results show that many people with dementia continue driving, and that it is difficult to prohibit their driving license renewals. Our research also explained the difference in driving behaviors between differing backgrounds of dementia. Accordingly, clinicians have to diagnose dementia and also conduct an evaluation, and it will be necessary to judge whether the patients should have their driver's license renewed in the future. On the other hand, the very real problem where a dementia patient's local life and activities are greatly reduced when their driving permission is rescinded still remains. These problems need to be urgently addressed in Japan.