Incipient Alzheimer's disease as the underlying cause of a motor vehicle crash.

A 75-year-old female driver died in a single vehicle crash. A forensic autopsy diagnosed the cause of death as blood loss due to laceration of the liver caused by the crash. Although she had neither clinical history of dementia nor gross abnormalities of the brain, neuropathological examinations showed a substantial number of senile plaques indicative of Alzheimer's disease (AD). An interview with a family member revealed that she had symptoms of dementia. Cognitive dysfunction due to AD was proposed as the underlying cause of the crash. It is recommended that forensic autopsy of older drivers should include neuropathological examinations to identify incipient AD. Recognition of AD as an underlying cause of crashes is also important to promote the health care of older people.