Guidelines that physicians use to assess fitness to drive for dementia are limited
in their currency, applicability, and rigor of development. Therefore, we performed
a systematic review to determine the risk of motor vehicle collisions (MVCs) or driving
impairment caused by dementia, in order to update international guidelines on driving
with dementia. Seven literature databases (MEDLINE, CINAHL, Embase, etc.) were searched
for all research studies published after 2004 containing participants with mild, moderate,
or severe dementia. From the retrieved 12,860 search results, we included nine studies
in this analysis, involving 378 participants with dementia and 416 healthy controls.
Two studies reported on self-/informant-reported MVC risk, one revealing a four-fold
increase in MVCs per 1,000 miles driven per week in 3 years prior, and the other showing
no statistically significant increase over the same time span. We found medium to
large effects of dementia on driving abilities in six of the seven recent studies
that examined driving impairment. We also found that persons with dementia were much
more likely to fail a road test than healthy controls (RR: 10.77, 95% CI: 3.00–38.62,
z = 3.65, p < 0.001), with no significant heterogeneity (χ2 = 1.50, p = 0.68, I2 = 0%) in a pooled analysis of four studies. Although the limited data regarding MVCs
are equivocal, even mild stages of dementia place patients at a substantially higher
risk of failing a performance-based road test and of demonstrating impaired driving
abilities on the road.
Key Words
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Article info
Publication history
Published online: May 15, 2017
Accepted:
May 11,
2017
Received in revised form:
April 28,
2017
Received:
January 24,
2017
Footnotes
PROSPERO International prospective register of systematic reviews (CRD42016039018).
1
Identification
Copyright
© 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
