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2 results

  • Chapter 13 - Driving and Dementia

  • Edited by Mathieu Vandenbulcke, KU Leuven, Belgium, Rose-Marie Dröes, Erik Schokkaert, KU Leuven, Belgium
  • Book:
    Dementia and Society
    Published online:
    26 May 2022
    Print publication:
    09 June 2022, pp 251-266

  • Summary

    Most people with early-stage dementia lead relatively independent lives and many remain active drivers for several years after diagnosis. Independent mobility and driving are important features of their quality of life and enable the individual to continue living at home, thus reducing the financial burden on society. However, dementia-associated cognitive impairment can impact the ability to drive safely. This leads to a potential conflict between the individual’s autonomy and the safety of other road users. Regulations concerning drivers with dementia differ across countries, and clinical assessment procedures to determine fitness to drive differ within and across countries. No single examination method can classify a driver as safe or unsafe with complete certainty. Once a person with dementia has been cleared for driving, regular follow-up is necessary to determine when driving should cease. Clinical experience shows that the issue of driving is sensitive for cognitively impaired people and caregivers. Even a severely impaired person may react strongly when learning that driving is no longer permitted, as this represents a threat to his or her self-esteem as well as a practical challenge. This needs to be recognized and dealt with appropriately in the healthcare context, presenting and discussing alternative modes of transportation.

  • Aiding medical professionals in fitness-to-drive screenings for elderly drivers: development of an office-based screening tool

  • Judith H.J. Urlings, Ariane Cuenen, Tom Brijs, Mark Lutin, Ellen M.M. Jongen
  • Journal:
    International Psychogeriatrics / Volume 30 / Issue 8 / August 2018
    Published online by Cambridge University Press:
    10 December 2017, pp. 1211-1225
  • Background:

    Elderly drivers are an increasing group in society. Previous research has found that functional and cognitive abilities are more important for driving abilities than biological age. In an attempt to conserve independent mobility for elderly drivers, many researchers have focused on elderly drivers diagnosed with cognitive decline (mild cognitive impairment or mild Dementia). This study is the first to focus on elderly drivers with cognitive complaints or suspected of diminished fitness to drive by an (in)formal caregiver as an at-risk group.

    Methods:

    The main objective of this study was to develop a fitness to drive screening tool for elderly drivers to be used in a doctor's office. Furthermore, this study investigated the additional value of driving simulator tests in the assessment of fitness to drive. Both screenings (functional abilities and driving simulator test) were benchmarked against the official Belgian fitness to drive licensing procedure.

    Results:

    One-hundred thirty-six elderly drivers participated in a functional abilities screening, a driving simulator assessment and an on-road driving test. Sixty-five percent of the sample was considered fit to drive. Visual acuity, physical flexibility, and knowledge of road signs were found to be the best predictive set of tests for the on-road fitness to drive outcome. A performance based driving simulator assessment increased predictive accuracy significantly.

    Conclusion:

    The proposed screening procedure saves part of the at-risk elderly driver population from stressful and costly on-road driving evaluations. This procedure provides more information of an individual driver's specific driving parameters. This opens doors for personalized older driver training to maintain independent mobility in later life.