Assessing fitness to drive
The driving task depends various aspects of cognitive function as well as sensory perception and motor function.[1]
No individual test or test of a single domain can definitively determine driving safety.[2] Avoid over-reliance on sMMSE scores. Instead, use a combination of aspects on history, examination and cognitive screening tools to determine if the patient is clearly safe, clearly unsafe or needs more testing.[3]
Also consider the presence of disability or medical conditions other than cognition (e.g. blackouts, seizures) that may affect fitness to drive according to Impact of medical conditions on driving | Austroads as well as reversible conditions or medications.
Test scores can be confounded by other factors such as communication or language difficulty and anxiety.
Suggested questions to ask the patient and family
Tools
1. Austroads Ltd. Assessing Fitness to Drive for commercial and private vehicle drivers. Sydney, Australia: Austroads Ltd; 2017.
2. Bennett JM, Chekaluk E, Batchelor J. Cognitive Tests and Determining Fitness to Drive in Dementia: A Systematic Review. Journal of the American Geriatrics Society. 2016;64(9):1904-17.
3. Molnar FJ, Byszewski AM, Rapoport M, Dalziel WB. Practical Experience-Based Approaches to Assessing Fitness to Drive in Dementia. Geriatrics and Aging. 2009;12(2):83-92.