@article{ref1,
title="Driving and Alzheimer's dementia or mild cognitive impairment: a systematic review of the existing guidelines emphasizing on the neurologist's role",
journal="Neurological sciences",
year="2021",
author="Stamatelos, Petros and Economou, Alexandra and Stefanis, Leonidas and Yannis, George and Papageorgiou, Sokratis G.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Driving is a complex task requiring the integrity and the cooperation of cognition, motor, and somatosensory skills, all of which are impacted by neurological diseases. <br><br>OBJECTIVE: Identification of neurologist's role when assessing fitness to drive of cognitively impaired individuals. <br><br>METHODS: We performed a systematic review of the guidelines/recommendations (G/Rs) regarding the evaluation of driving fitness of patients with mild cognitive impairment (MCI) and/or dementia. Emphasis was put on the neurological and neuropsychological aspects of the evaluation. <br><br>RESULTS: Eighteen G/Rs were included in the review (9 national guidelines, 5 recommendation papers, 3 consensus statements, and 1 position paper). All G/Rs referred to drivers with dementia and 9/18 referred to drivers with MCI. A common approach among G/Rs is the initial trichotomization of patients in safe to drive, unsafe to drive, and undetermined cases, which are referred to a second-line evaluator. First-line evaluators are general practitioners in 10/18 G/Rs; second-line evaluators are neurologists in 7/18 G/Rs. Specific neuropsychological tests are proposed in 11/18 G/Rs and relative cut-off values in 7/18. The most commonly used tests are the MMSE, TMT, and CDT. A thorough neurological examination is proposed in only 1/18 G/R. <br><br>CONCLUSION: Although extensive multi-disciplinary research has provided useful information for driving behavior of cognitively impaired individuals, we are still far from a widely accepted approach of driving ability evaluation in this increasing population. A comprehensive assessment from a multi-disciplinary team in which the neurologist plays a critical role seems to be required, although this has not yet been implemented in any G/Rs.<p /> <p>Language: en</p>",
language="en",
issn="1590-1874",
doi="10.1007/s10072-021-05610-7",
url="http://dx.doi.org/10.1007/s10072-021-05610-7"
}