The effects of aging on cognitive performance are important in safety critical activities such as aviation especially when dealing with novel or inflight emergency events. The ability to perform safely on cognitively demanding tasks requires good executive functioning and spatial working memory. Older experienced pilots tend to show preserved spatial working memory. But even mild cognitive impairment may adversely affect the ability to cope with the complex and high task level demands characteristic of aviation, including in experienced pilots. Cognitive impairment may not be recognised by the applicant.
Dementia (cognitive and behavioural problems severe enough to impair normal function) is incompatible with certification.
It is important to have an index of suspicion in older pilots. Mild cognitive impairment may not interfere with normal daily activities but is a potential significant risk to flight safety.
A ME should ask about the applicant’s flying since their last application, how well they manage different situations, difficulties flying a different aircraft type, flight planning, or with procedural activities such as cockpit or ATC communications. Information about any recent flying related incidents or near misses should be reviewed. Other collateral information that may be covered by the ME include changes in daily or work activities, recent motor vehicle accidents, or problems managing personal affairs such as financial matters.
MEs may use office based tests such as Montreal Cognitive Assessment (MOCA) as an initial screen or using the CAA aging pilot form. Unfortunately, many of the simple tests of cognition available to MEs are unlikely to pick up mild but aeromedically significant cognitive impairment.
Formal neurocognitive testing may be needed in some situations, but it is recommended that MEs contact CAA to discuss this before proceeding with such evaluations.
A ME should consider requesting a copy of the most recent BFR / competency flight check report. A CAA flight examiner assessment may be required, specifically to test decisionmaking and flight planning skills, as well as procedural tasks.