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Chapter 10 - Driving in Dementia

A Clinician’s Guide

from Section 2 - Assessment and Investigations

Published online by Cambridge University Press:  12 September 2020

By
Sarah Wilson  and
Gill Pinner
Edited by
Julian C. Hughes  and
Philippa Lilford
Julian C. Hughes
Affiliation:
University of Bristol
Philippa Lilford
Affiliation:
Severn Deanery, University of Bristol
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Summary

With an ageing population and more drivers on the road, the number of drivers with dementia is due to grow exponentially over the next 50 years. Although decisions regarding possession of a driving licence in the UK are made by the Driver and Vehicle Licensing Agency (DVLA), psychiatrists need to consider the DVLA guidance and inform patients and their carers of their responsibility to remain safe and legal on the roads. Doctors have a duty of care to advise patients who are unfit to drive to cease driving and to inform the DVLA of patients who pose a risk to the general public by continuing to drive when advised not to. This chapter offers a review of the literature on dementia and driving and summarizes the evidence and advice for navigating this minefield, including the recently published consensus guidelines for driving with dementia or mild cognitive impairment (MCI).

Type
Chapter
Information
Clinical Topics in Old Age Psychiatry , pp. 139 - 148
Publisher: Cambridge University Press
Print publication year: 2020

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References

UK Guideline Development Group. Driving with Dementia or Mild Cognitive Impairment: Consensus Guidelines for Clinicians, Newcastle University, 2018. Last accessed on 12 September 2019 via: https://research.ncl.ac.uk/driving-and-dementia/consensusguidelinesforclinicians/Final%20Guideline.pdfGoogle Scholar
Holland, C. Self-bias in older drivers’ judgments of accident likelihood. Accid Anal Prev 1993; 25: 431–441.CrossRefGoogle ScholarPubMed
Johnson, J. Older rural adults and the decision to stop driving: the influence of family and friends. J Community Health Nurs 1998; 15: 205–216.Google Scholar
Adler, G, Rottunda, S, Bauer, M, et al. Driving cessation and Alzheimer’s Dementia: issues confronting patients and family. Am J Alzheimers Dis Other Demen 2000; 15: 212–216.Google Scholar
Brown, L, Ott, B, Papandonatos, D, et al. Prediction of on-road driving performance in patients with early Alzheimer’s disease. J Am Geriatr Soc 2005; 53: 94–98.CrossRefGoogle ScholarPubMed
Croston, J, Meuser, T, Berg-Weger, M, et al. Driving retirement in older adults with dementia. Top Geriatr Rehabil 2009; 25: 154–162.Google Scholar
Trobe, J, Waller, P, Cook-Flannagan, C, et al. Crashes and violations among drivers with Alzheimer disease. Arch Neurol 1996; 53: 411–416.Google Scholar
Carr, D, Duchek, J, Morris, J. Characteristics of motor vehicle crashes of drivers with dementia of the Alzheimer type. J Am Geriatr Soc 2000; 48: 18–22.Google Scholar
British Psychological Society (BPS). Fitness to Drive and Cognition: A Document of the Multi-Disciplinary Working Party on Acquired Neuropsychological Deficits and Fitness to Drive 1999. BPS, 2001. Last accessed on 12th September 2019 via: www.assessmentpsychology.com/fitness_to_drive.pdfGoogle Scholar
Wood, J, Worringham, C, Kerr, G, et al. Quantitative assessment of driving performance in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2005; 76: 176–180.Google Scholar
Dubinsky, R, Stein, A, Lyons, K. Practice parameter: risk of driving and Alzheimer’s disease (an evidence-based review): report of the quality standards subcommittee of the American Academy of Neurology. Neurology 2000; 54: 2205–2211.CrossRefGoogle Scholar
Hopkins, R, Kilik, L, Day, D, et al. Driving and dementia in Ontario: a quantitative assessment of the problem. Can J Psychiatry 2004; 49: 434–438.Google Scholar
Breen, D, Breen, D, Moore, J, et al. Driving and dementia. Brit Med J 2007; 334: 1365–1369.CrossRefGoogle ScholarPubMed
Gilley, D, Wilson, R, Bennett, D, et al. Cessation of driving and unsafe motor vehicle operation by dementia patients. Arch Intern Med 1991; 151: 941–946.Google Scholar
Langford, J, Methorst, R, Hakamies-Blomqvist, L. Older drivers do not have a high crash risk – a replication of low mileage bias. Accid Anal Prev 2006; 38: 574–578.Google Scholar
Man-Son-Hing, M, Marshall, S, Molnar, F, Wilson, K. Systematic review of driving risk and the efficacy of compensatory strategies in persons with dementia. J Am Geriatr Soc 2007; 55: 878–884.Google Scholar
Marottoli, R, Mendes de Leon, C, Glass, T, et al. Consequences of driving cessation: decreased out-of-home activity levels. J Gerontol B Psychol Sci Soc Sci 2000; 55B: S334–S340.Google Scholar
Foley, D, Heimovitz, H, Guralnik, J, Brock, D. Driving life expectancy of persons aged 70 years and older in the United States. Am J Public Health 2002; 92: 1284–1289.CrossRefGoogle ScholarPubMed
Marottoli, R, Mendes de Leon, C, Glass, T, et al. Driving cessation and increased depressive symptoms: prospective evidence from the New Haven EPESE. J Am Geriatr Soc 1997; 45: 202–206.Google Scholar
Rosser, M. Dementia and driving: European National Guidelines. Eur J Neurol 2000; 7: 745.Google Scholar
Driver and Vehicle Licensing Agency. Assessing Fitness to Drive: A Guide for Medical Professionals. DVLA, 2019.Google Scholar
Naidu, A, McKeith, I. Driving, dementia and the Driver and Vehicle Licensing Agency: a survey of old age psychiatrists. Psychiatr Bull 2006; 30: 265–268.Google Scholar
General Medical Council (GMC). Confidentiality: Patients’ Fitness to Drive and Reporting Concerns to the DVLA or DVA. GMC, 2019.Google Scholar
Molnar, F, Patel, A, Marshall, S, et al. Clinical utility of office-based cognitive predictors of fitness to drive in persons with dementia: a systematic review. J Am Geriatr Soc 2006; 54: 1809–1824.Google Scholar
Wiseman, E, Souder, E. The older driver: a handy tool to assess competence behind the wheel. Geriatrics 1996; 51: 36–45.Google Scholar
Man-Son-Hing, M, Marshall, S, Molnar, F, et al. A Canadian research strategy for older drivers: the CanDRIVE Program. Geriatrics Today: J Can Geriatr Soc 2004; 7: 86–92.Google Scholar
Champlain Dementia Network, Regional Geriatric Program of Eastern Ontario. The Driving and Dementia Toolkit for Health Professionals (3rd Edn), 2009. Last accessed on 12 September 2019 via: www.rgpeo.com/media/30695/dementia%20toolkit.pdfGoogle Scholar
Molnar, F, Byszewski, A, Marshall, S, Man-Son-Hing, M. In-office evaluation of medical fitness to drive: practical approaches for assessing older people. Can Fam Physician 2005; 51: 372–379.Google Scholar
Lincoln, N, Radford, K, Lee, E, Reay, A. The assessment of fitness to drive in people with dementia. Int J Geriatr Psychiatry 2006; 21: 1044–1051.Google Scholar
McKenna, P, Jefferies, L, Dobson, A, Frude, N. The use of a cognitive battery to predict who will fail an on-road driving test. Brit J Clin Psychol 2004; 43: 325–336.CrossRefGoogle ScholarPubMed
McKenna, P. Fitness to drive: a neuropsychological perspective. J Ment Health 1998; 7: 9–18.Google Scholar

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