Driving and dementia

doi:10.1136/bmj.39233.585208.55

BMJ 2007;334:1365-1369 (30 June), doi:10.1136/bmj.39233.585208.55

Clinical Review

Driving and dementia

David A Breen, consultant in public health medicine¹, David P Breen, foundation year 2 doctor in combined assessment medicine², John W Moore, consultant clinical neuropsychologist¹, Patricia A Breen, staff grade in old age psychiatry¹, Desmond O'Neill, associate professor of medical gerontology³

¹ NHS Dumfries and Galloway, Dumfries, Scotland, ² Royal Infirmary of Edinburgh, Edinburgh, Scotland, ³ Trinity College, Dublin, Republic of Ireland

Correspondence to: D O'Neill, Department of Medical Gerontology, Trinity Centre for Health Sciences, Adelaide and Meath Hospital, Dublin 24, Republic of Ireland arhc@amnchi.ie

The first 150 words of the full text of this article appear below.

Summary points

Many people with early dementia are capableof driving safely

Evidence suggests that the risk of crashesin drivers with dementia is low for up to three years afterdisease onset, but this varies between people

The Driver andVehicle Licensing Agency must be notified of all new diagnosesof Alzheimer's disease and other dementias: this relies primarilyon self reporting

The doctor's role is to make an immediatedecision on safety to drive and to ensure that the licensingagency is notified

Cognitive testing cannot determine whetherindividuals with early dementia are able to drive safely

Thechallenge for doctors and the licensing agency is to balancemobility and safety in a growing population of older drivers

Dementia is important in relation to driving. As the diseaseprogresses the ability to drive safely is eventually lost andat that point current regulations demand that driving stops.Many patients continue . . . [Full text of this article]

Sources and selection criteria

Crash data

Who decides on medical fitness to drive?

What should I do in the clinic?

Box 1: Guidelines from the Driver and Vehicle Licensing Agencyif medical conditions could affect safe driving¹⁵
Age
Dementia

How does the Driver and Vehicle Licensing Agency make its decision?

What is the role of cognitive function testing?

Relicensing for drivers with dementia in the European Union and North America

Conclusions

A medical perspective
Additional educational resources
Patient and carer information
Assessment of medicalfitness to drive
Olderpeople and transport