Systematic Review of Driving Risk and the Efficacy of Compensatory Strategies in Persons with Dementia

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 55; no. 6; pp. 878 - 884
• Main Authors: Man-Son-Hing, Malcolm, Marshall, Shawn C., Molnar, Frank J., Wilson, Keith G.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.06.2007; Blackwell; Wiley Subscription Services, Inc
• Subjects: Accidents, Traffic - prevention & control; Accidents, Traffic - psychology; Automobile drivers; Automobile Driving - psychology; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Dementia - psychology; driving; General aspects; Humans; Medical sciences; Miscellaneous; motor vehicle crashes; Neurology; Older people; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Assessment; Risk factors; systematic review; Traffic accidents & safety; Human; Nervous system diseases; Vehicle driving; Traffic accident; Systematic review; Risk; Motor vehicle; Evidence-based medicine; Cerebral disorder; Senile dementia; driving; Gerontology; Central nervous system disease; Risk factor; Strategy; dementia; Degenerative disease; motor vehicle crashes; Elderly; Bibliographic review; Geriatrics
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2007.01177.x

OBJECTIVES: To determine whether persons with dementia are at greater driving risk and, if so, to estimate the magnitude of this risk and determine whether there are efficacious methods to compensate for or accommodate it. DESIGN: Systematic review of the literature. SETTING: Case‐control studies. PARTICIPANTS: Drivers with a diagnosis of dementia. MEASUREMENTS: Most studies used state and caregiver reported crash rates, performance‐based road tests, and driving simulator evaluations as their outcome measures. RESULTS: Twenty‐three studies were included. Drivers with dementia universally exhibited poorer performance on road tests and simulator evaluations, although only one study using an objective measure of motor vehicle crashes was able to show that drivers with dementia were involved in more crashes than control subjects. No studies were found that examined the efficacy of methods to compensate for or accommodate their worse driving performance. CONCLUSION: Drivers with dementia are poorer drivers than cognitively normal drivers, but studies have not consistently demonstrated higher crash rates. Clinicians and policy makers must take these findings into account when addressing issues pertinent to drivers with a diagnosis of dementia.