Story ID: 
AINsight: Cognitive Decline in Aging Pilots
By: Stuart “Kipp” Lau
Caption: A proposed bill in Congress would raise the mandatory retirement age for airline pilots from 65 to 67 without first examining the effects of aging.
Word Count: 1639
Congress is debating raising the mandatory retirement age of airline pilots to curb flight cancellations caused by a shortage of pilots. The legislation—called “Let Experienced Pilots Fly Act”—introduced by Sen. Lindsey Graham (R-South Carolina) and five other Republican Senators is a “stopgap” measure that would keep airline pilots on the flightdeck for two additional years, raising the mandatory retirement age from 65 to 67 years of age.
If this proposal becomes law, there will be no changes to current medical certification standards, such as assessments of cognitive abilities, for these older pilots. Likewise, there are no proposed changes to pilot training and qualification programs.
Graham said his proposed legislation “extends the mandatory retirement age by two years and will make an immediate and appreciable difference in keeping highly-trained pilots on the job.” He added, “We have a crisis when it comes to airline travel—we have a pilot shortage and those who say we don’t, well they are just full of it.”
Republican backers of the proposed bill say roughly 5,000 fully qualified pilots will be forced to retire over the next two years simply because they reach the mandatory retirement age of 65. According to Graham, baby boomers make up half of the airline pilot population. The youngest of these “boomers” today would be 58 years old.
Citing medical reports from 2007—when the retirement age was increased from 60 to 65 years—these lawmakers say raising the retirement age of airline pilots will have an “insignificant impact” on performance in the cockpit.
Here is the problem: Graham and his friends on Capitol Hill are missing the point. The purpose of a mandatory pilot retirement age, as accepted around the globe, is to limit the risks associated with aging crewmembers.
The regulation today arbitrarily picked 65 as the age limit and provides no guarantee that a pilot is cognitively fit to fly. The fact is all aging adults experience some level of cognitive decline, from airline pilots to lawmakers. Cognitive decline can begin as early as age 45 and affects everyone differently and is difficult to predict.
Cognitive decline is the condition of having memory loss, reduced or slower thinking skills, or other impairment in mental capabilities. Aging affects other executive functions such as the ability to self-monitor, plan, organize, reason, problem solve or be mentally flexible (or as an alternative, aging adults become mentally rigid and have difficulty accepting beliefs other than their own).  
Regarding aviation safety, there are temporary cognitive inefficiencies, disturbances, or deficiencies in function, either stable or progressive, due to fatigue, injury, medication, illness, or substance use—these are periods where a pilot is unfit to fly. A cognitive disability, such as the early onset of Alzheimer’s disease, is disqualifying and the pilot is permanently unfit to fly.
In a 2014 article published by the Flight Safety Foundation, Dr. Quay Snyder, president and founder of Virtual Flight Surgeons, said, “Cognitive decline, most prevalent among aging pilots, is a threat to safety that is similar to fatigue and substance abuse.”
Quay continued, “Like the effects of fatigue and substance abuse, cognitive deficiencies are insidious, have a substantial negative impact on performance, and are hardest to identify when the crewmember is performing routine activities.” Over time, the brain adjusts to mild or moderate cognitive impairment, masking the severity of the deficiency.
The Seattle Longitudinal Study, which tracks the cognitive performance of aging individuals has identified six key factors in cognitive performance such as inductive reasoning (problem solving), spatial orientation, perceptual speed (pace of understanding), numeric ability, verbal ability, and verbal memory. 
The study shows that, on average, cognitive skills remain good through age 60, with verbal skills remaining acute longer than other cognitive skills such as spatial orientation or perceptual speed. In other words, the study’s author said, “as the error rates increases in other areas, the subject’s ability to talk his way out of it remains high.”
In 2019, Scientific Reports published a study from the University of Toulouse (Causse, Chua, and Remy) that examined the influences of age, mental workload, and flight experience on cognitive performance in pilots. The basis of this research was to better understand the effects of aging and cognitive performance to protect individuals who are engaged in risky activities. This study examined pilots aged 55 or older. 
According to the University of Toulouse study, “The potential deterioration of cognitive performance with advancing age becomes an absolute element of concern in this kind of risky activity, probably more than the age-related physical incapacitations.”
The study was conducted to increase the knowledge on how age affects specific intellectual functions, which are critical to efficient and safe piloting. An outcome of the study determined that certain executive functions needed during piloting are affected with aging, such as working memory, spatial attention, and/or inhibition—all prefrontal lobe activities. 
During the study there was a focus on spatial working memory (SWM), which requires retention and manipulation of visuospatial information. A great example of exercising SWM functions is the electronic memory game Simon. On the flight deck, a good example of a complex SWM task would be an ATC reroute with a route modification in the flight management computer. 
The study examined the performance of SWM in three different age groups: young, middle, and old. Generally, young, and middle-aged pilots performed about the same throughout the study, but older pilots—those over 60—would commit more errors as the task became more difficult. 
In the U.S. the “catch all” regulation (FAR 61.53) to prevent pilots from flying “unfit” states, “No person who holds a medical certificate issued under Part 67…may act as a crewmember, while that person: (1) knows or has reason to know of any medical condition that would make that person unable to meet the requirements of the medical certificate.” 
In business aviation, the conversation surrounding aging pilots becomes more interesting since there is no federal mandate forcing a pilot to retire. The only regulation preventing a pilot from flying with a disqualifying cognitive decline or other medical condition is 61.53, which relies on “self-reporting” by the individual. 
Self-reporting medical conditions is a challenge in aviation since the reporter is likely “under the influence.” A cognitive impairment is no different than fatigue or an alcohol or drug impairment.
Pilots often use flying as a sense of identity—an avocation versus a vocation—and are unlikely to self-report due to a sense of losing that identity. Furthermore, if a pilot takes themselves “out of the game” there may be undesirable economic or financial pressures, since flying is how they make their livelihood.
For a flight department, creating a policy based solely on age may clash with state and federal laws on discrimination and health care privacy issues. A corporate policy on a mandatory retirement age is rare and wrought with legal implications.
The final option for a cognitive assessment would be to implement a formal or informal screening process. In a perfect world, an operator with a robust “just culture” would encourage a pilot to self-report or participate in a peer-to-peer evaluation. This could provide an “off ramp” for the aging pilot suffering from a cognitive decline—the operator could support this individual with loss of license or disability insurance. 
Other options could include a more formal approach to cognitive testing and evaluation either through the Aviation Medical Examiner (AME) network or during recurrent training with a training provider. Cognitive assessments are highly specialized and require a unique professional set of skills—AMEs and flight training center examiners are unlikely to accept the liability of deciding that a pilot is unfit to fly due to a cognitive impairment. 
Proponents of the “Age 67” rule look to it as providing short-term supply of experienced pilots to “fill the seats” for a couple more years. The Regional Airline Association supports this bill since at last count there were nearly 500 regional jets parked due to a lack of pilots. 
Opponents, namely the large pilot unions, claim that there is no pilot shortage, only “a lack of a plan” from airline management since they squandered $50 billion in taxpayer funding on early pilot retirements without training new pilots to fill those seats. 
United Airlines provides a unique perspective. In a CNBC interview, United CEO Scott Kirby said he does not think raising the retirement age is the solution. “At United, of our age 64 pilots, 36 percent are unavailable to fly on a given day for sick, short-term, or long-term medical reasons,” he noted. 
Transportation Secretary Pete Buttigieg also expressed his concerns, “Look, these retirement ages are there for a reason and the reason is safety. I’m not going to be on board with anything could jeopardize safety.”
Buttigieg continued, “The answer is not to keep the baby boomer generation in the cockpit indefinitely. The answer is to make sure that we have as many good pilots ready to take their place; to have a stronger pipeline.” 
Political pundits believe that Graham’s “Let Experienced Pilots Fly Act” is on hold until the mid-term elections on November 8. A strong showing from Republicans will likely reinvigorate the “Age 67” bill to appease the traveling public. From a safety perspective, it would be difficult to support any change to the current law without first examining the effects of aging in the pilot population.The opinions expressed in this column are those of the author and not necessarily endorsed by AIN Media Group.