Years ago, my father, a retired engineer, had come out of a dental office and couldn't understand why my mother was not there to pick him up. When he called the house, my mother gently reminded him that he had driven there. My mother headed to the office and helped him find his car, but he insisted on driving it home himself. She followed him but was helpless to prevent him from rear-ending another vehicle on the way home. We knew then that it was time to take away his keys. It was a difficult conversation, but we worried that if we didn't intervene, he would injure himself or others.
My father had been living with Parkinson's disease for about six years at the time, and I later wondered if different factors—mild changes in cognitive function, slowness of movement and reaction time, and subtle tremors—had all contributed to his fender benders. Driving safely requires many skills, including strength, vision, hearing, multi-tasking, and visuospatial abilities. In this issue, we address the question many families and caregivers ask: When is it time to stop driving?
As a nod to Parkinson's Awareness Month in April, we feature actor Ed Begley Jr., who describes his long road to a diagnosis of Parkinson's disease and all he does to stay active. He goes to the gym every morning, does upper-body circuits, and rides a stationary bike. Research shows that exercise—including activities like boxing, tai chi, rock climbing, yoga, dance, and swimming—is especially good for people with Parkinson's disease. For another fun activity, check out this issue's story on table tennis.
If your memory or a loved one's isn't what it once was, you'll want to read our feature on mild cognitive impairment and how it differs from normal aging and dementia. We hope this story alleviates concerns and lets you know when a visit to the neurologist is warranted. If you do go for an evaluation, the workup may include an imaging test. Our Ask Your Neurologist column distinguishes among CTs, MRIs, and PET scans and explains why each is prescribed.
Everyone deserves to look and feel their best, but a visit to a hair or nail salon can be fraught with obstacles for people with neurologic conditions that impair movement. We asked beauty professionals and customers for advice on making these visits more accessible and relaxing.
My favorite story in this issue is about programs that bring seniors and children together in a variety of ways—among them, gardening, arts and crafts, storytelling, and playing or listening to music. Unsurprisingly, both the older people and the kids enjoy the interactions and learn a great deal from one another. The experience of one of my sons is a case in point. When he was in elementary school, he would read detective stories to a man in a nursing home who had lost his vision. The resident, who had had a long career in law enforcement, regaled my son with stories from the field, and the two stayed close until the gentleman's death.
A big thanks to all our readers who shared their stories of learning new skills and encouraging neuroplasticity. You will find some of their examples in this issue's Letters. As we head into spring, please share the ways you stay physically active, whether that's dancing, walking, chair yoga, or something else—and how it helps you manage your neurologic condition.
Orly Avitzur, MD, MBA, FAAN, Editor in Chief
