Judi Dench has stopped driving: How to know when you should, too

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Being a passenger may be one of Dame Judi Dench’s most challenging roles yet.

The celebrated actress got candid about her health in a recent RadioTimes interview, revealing that she cannot drive anymore due to her deteriorating eyesight from macular degeneration.

“A couple of years ago I stopped driving, which was one of the most traumatic moments of my life,” said Dench, 84, who will make a brief cameo in the next “James Bond” film. “It was absolutely appalling. But I just know I’ll kill somebody if I get behind the wheel of a car now.”

Dench, a seven-time nominee who earned an Academy Award for playing Queen Elizabeth I in 1998’s “Shakespeare in Love,” first disclosed that she has age-related macular degeneration, or AMD, in 2012. With the affliction, the retina develops lesions that debilitate a person’s central field of vision.

“Your eye is a camera, and we have a lens [behind the pupil], and the film is the retina [which is light-sensitive and focuses images],” Dr. Avnish Deobhakta, a retina surgeon at New York Eye and Ear Infirmary of Mount Sinai, told MarketWatch. And in more advanced cases like Dench’s, these lesions accrue under the center part of the retina, which interferes with near-vision tasks like reading, recognizing faces and seeing well enough to pass the eye exam for a driver’s license.

Symptoms can include: blurred or fuzzy vision; seeing what should be straight lines — such as the edge of a door or sentences on a page — as crooked or wavy; viewing some objects as smaller than they really are; and the appearance of a gray, dark or empty area in the center of the field of vision.

Dench is one of 196 million people around the world expected to be living with AMD by 2020, which is the third leading cause of vision loss after cataracts and glaucoma. AMD currently affects more than 10 million Americans, according to the American Macular Degeneration Foundation, and is most likely to occur in adults over 55, particularly women (because they’re more likely to live longer than men) and Caucasians. People with a genetic history of AMD are also more prone to develop the disease, and smoking can double the risk, as well.

There are treatments for AMD, such as wearing glasses that help you use other parts of your retina to see, as well as eye injections to slow down AMD progression and to preserve vision. Nutritional therapies, such as eating a diet high in antioxidants to support cells in the eye, can also help.

“The No. 1 myth about macular degeneration is that fear of ‘I’m going to go blind,’ and even in the most severe cases of macular degeneration, your field of vision is not going all black,” assured Dr. Deobhakta. “(But) you have to have 20/40 vision in at least one eye to drive, and the problem with this disease is that it affects both eyes. So a lot of patients will eventually have to give up things like driving.”

Indeed, Dench didn’t stop driving until 2017, about five years after she revealed her diagnosis. “I can’t read the paper now, I can’t do the crossword, I can’t read a book,” Dench said in her recent interview. “(But) I can see enough.”

Research has shown that older adults who have AMD report greater difficulty driving than do older adults who do not have AMD, and so many like Dench self-regulate their driving to stay safe. In other words, they will adjust when they drive (such as not driving at night, which can be difficult for this with impaired central vision), under what circumstances they drive, and how often they take the wheel. In fact, a 2013 study found that older drivers with intermediate AMD had a significantly lower risk of getting into car crashes compared to people with normal vision, which researchers suggested was because those with AMD were careful to avoid potentially dangerous driving situations.

Related: 5 signs it’s time for your parents to stop driving

It can be difficult for people to recognize their own potential impairments before getting behind the wheel, however — including chronic health conditions that could mean it’s time to hand their license over and stick to cabs and ride shares like Lyft LYFT, -1.67%  and Uber UBER, -1.37% Driving is an important part of maintaining independence and competence, which is why 82% of drivers ages 55 to 101 said continuing to drive was “very or extremely important to them” in a 2016 study. But most of those drivers also agreed that they would consider handing over the keys if they had a health condition or if a medical professional advised them to stop driving.

An estimated 40,000 people died in car crashes last year, and another 4.5 million were seriously injured, according to the National Safety Council. Every seven seconds, someone is hurt in a car crash. A 2015 National Highway Traffic Safety Administration study calculated that motor vehicle crashes cost the economy $871 billion a year.

The AARP has drawn up the following list of warning signs of unsafe driving to look for in yourself or someone else, which could mean it’s time to pull over:

  • Delayed response to unexpected situations
  • Becoming easily distracted while driving
  • A decrease in confidence while driving
  • Having difficulty moving into or maintaining the correct lane of traffic
  • Hitting curbs when making right turns or backing up
  • Getting scrapes or dents on the car, garage or mailbox
  • Having frequent close calls
  • Driving too fast or too slow for road conditions

And AAA has also drawn up some common warning signs that it’s time to stop driving, including:

  • Confusion between the gas and brake pedals, or if there is difficulty in working them (which could be a sign of weakening leg strength)
  • Seeming to ignore or miss traffic signals, especially stop signs
  • Not signaling when changing lanes, or not checking mirrors and blind spots
  • Any type of cognitive decline, which could lead to get lost or becoming disoriented

If you are concerned about the ability of a spouse, parent, relative or friend’s ability to drive, but you don’t know how to begin this difficult conversation, the AARP has also created a free We Need to Talk online seminar with insurance company The Hartford and the MIT AgeLab to guide you through the difficult conversation.

Bottom line: if you are worried about your health or driving ability, see a health professional — not only for peace of mind, but also for treatments that can hopefully get you back on the road. The sooner you catch any vision abnormalities, the better.

“If you notice anything unusual with your vision, it doesn’t mean you definitely have macular degeneration; it could be something else that is also fixable, so just go to an eye specialist if you have any concerns about your ability to drive,” said Dr. Deobhakta.

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