Citation

Carr DB, Stowe JD, Morris JC. Handb. Clin. Neurol. 2019; 167: 563-573.

Affiliation

Department of Neurology and Director, Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO, United States. Electronic address: morrisj@abraxas.wustl.edu.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/B978-0-12-804766-8.00031-5

PMID

31753155

Abstract

Driving is a complex, multifaceted instrumental activity of daily living that has an independent influence on multiple health and well-being outcomes among older adults. Therefore, the benefits of driving to the individual must be balanced, through careful assessment and diagnosis, with the potential risk to self and others posed by a medically impaired driver. The influence of dementia changes substantially during the disease progression from very mild to mild, and driving is not advised for those who have progressed to the moderate stage of Alzheimer disease. Fortunately, validated high-quality screening instruments, including modern simulators and other technology aids, can help clinicians trichotomize risk (i.e., high, moderate, or low) and determine which patients need further evaluation by a driving specialist (e.g., those in the moderate range). Moreover, a body of evidence is building regarding the efficacy of certain intervention pathways to maintain current levels of driving performance among individuals with dementia, or at least slow its decline. Even with the progression of advanced driving technologies, understanding driving ability of patients with dementia will remain a critical challenge to clinicians for the foreseeable future.

Copyright © 2019 Elsevier B.V. All rights reserved.

Language: en

Keywords

Alzheimer disease; Dementia; Driving; Driving simulator; Mild cognitive impairment; Motor vehicle crash