Cognitive Decline and Driving Evaluation in the Older Population

Book
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
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Excerpt

Cognitive decline can be described as a gradual or sudden loss of thinking abilities such as learning, paying attention and remembering past events/details.This is more commonly seen in the older adults with dementia. When taking care of patients with dementia (PWD), it is important to assess the patient’s fitness to drive. Patients with dementia have a 2-8x increased risk of motor vehicle accidents compared to similarly aged drivers without dementia, yet many are never counseled on driving safety.

Driving safety assessment is a sensitive discussion that is often delayed or forgone altogether because of physician reluctance, patient refusal, or caretaker preference. Physicians often are not formally trained on how to conduct these conversations and seldom do not conduct the assessment. Driving is integral to a patient’s independence, so discussions of driving fitness may be met with emotional resistance, and patients may not recognize or admit their deficits.

The true extent of driving impairment may be minimized by caretakers who either do not want to admit the progression of their loved one’s disease or do not want to take on additional driving responsibilities. Despite these barriers, driver safety assessment is an important public health and medicolegal issue and should be familiar to all healthcare professionals. See Driving Screening Flowchart below:

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