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Abstract
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OBJECTIVE: Older drivers with dementia are an at-risk group for unsafe driving. However, dementia refers to various aetiologies and the question is whether dementias of different aetiology have similar effects on driving ability.
METHODS: The literature on the effects of dementia of various aetiologies on driving ability is reviewed. Studies addressing dementia aetiologies and driving were identified through PubMed, PsychINFO and Google Scholar.
RESULTS AND CONCLUSIONS: Early symptoms and prognoses differ between dementias of different aetiology. Therefore, different aetiologies may represent different likelihoods with regard to fitness to drive. Moreover, dementia aetiologies could indicate the type of driving problems that can be expected to occur. However, there is a great lack of data and knowledge about the effects of almost all aetiologies of dementia on driving. One could hypothesize that patients with Alzheimer's disease may well suffer from strategic difficulties such as finding a route while patients with frontotemporal dementia are more inclined to make tactical level errors because of impaired hazard perception. Patients with other dementia aetiologies involving motor symptoms may suffer from problems on the operational level. Still, the effects of various aetiologies of dementias on driving have thus far not been studied thoroughly. For the detection of driving difficulties in patients with dementia, structured interviews with patients but also their family members appear crucial. Neuropsychological assessment could support the identification of cognitive impairments. The impact of such impairments on driving could also be investigated in a driving simulator. In a driving simulator, strengths and weaknesses in driving behaviour can be observed. With this knowledge, patients can be advised appropriately about their fitness to drive and options for support in driving (e.g. compensation techniques, car adaptations). However, as long as no valid, reliable, and widely accepted test battery is available for the assessment of fitness to drive, costly on-road test rides are inevitable. The development of a fitness-to-drive test battery for patients with dementia could provide an alternative for these on-road test rides, on condition that differences between dementia aetiologies are taken into consideration.
Language: en |