For patients with dementia, consider the following characteristics useful for identifying patients at increased risk for unsafe driving (Strength of evidence: A, B &C- Level A being highest and Level C is lowest strength of evidence):
• The CDR scale (Level A)
• A caregiver’s rating of a patient’s driving ability as marginal or unsafe (Level B)
• A history of traffic citations (Level C)
• A history of crashes (Level C)
• Reduced driving mileage (Level C)
• Self-reported situational avoidance (Level C)
• MMSE scores of < 24 (Level C)
• Aggressive or impulsive personality characteristics (Level C).
Patients with mild dementia (CDR of 1) are at a substantially higher risk for unsafe driving and thus should strongly consider discontinuing driving. The ORDT (On Road Driving Test) pass rate is 41-76% for CDR score of 1.
Source: Neurology 2010;74:1316–1324.
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Dr. Harvinder Singh, M.D. (Admin)
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