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CLINICAL REVIEW: David A Breen, David P Breen, John W Moore, Patricia A Breen, and Desmond O'Neill Driving and dementia BMJ 2007; 334: 1365-1369 [Full text]

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Driving and dementia

David J. Jolley   (3 July 2007)

Driving and dementia 3 July 2007
David J. Jolley, Consultant Psychiatrist/Hon Reader PSSRU, Dover Street, Manchester M13 9PL Send response to journal: Re: Driving and dementia	This is a very helpful paper which puts the matter into perspective, pointing toward sensible practical management. Older people are encouraged to maintain independence and many retain high expectations of quality activities, including travel. At the same time they are encouraged to present early to services for the identification and treatment of problems which might otherwise advance to produce greater impairment. Labelling an individual as a case of ‘Alzheimer’s’ or ‘Depression’ exposes them to a bureaucracy which can be intimidating, though designed to be helpful. This is a dilemma recognised internationally. It sometimes leads people to avoid appointments which might make them better, but might take away their wheels (1,2). The process of determining a safe resolution for an individual can tie up scarce resources perhaps inappropriately (3) as well as antagonising the patient and sometimes other family members. For the most part, sensible interpretations can be achieved by clinical assessment in association with family discussion – backed up when there is disagreement or uncertainty by a DVLA Test centre appraisal. (1) Boustani M. Perkins A.J. Fox C. Unverzagt F. Austrom M.G. Fultz B. Hui S. Callahan C.M. Hendie H.C. Who refuses the diagnostic assessment for dementia in primary care. International Journal of Geriatric Psychiatry 2006: 21(6) 556-563 (2) Werner P. Family physicians’ perceptions and predictors regarding the competence of a person with Alzheimer’s disease. International Journal of Geriatric Psychiatry 2007: 22(4) 320-326 (3) Lincoln N.B. Radford K.A. Lee E. and Reay A.C. The assessment of fitness to drive in people with dementia. International Journal of Geriatric psychiatry 2006: 21(11) 1044-1051 Competing interests: None declared