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Review
. 2005 Mar;51(3):362-8.

Which older patients are competent to drive? Approaches to office-based assessment

David B Hogan  1
Affiliations
Review

Which older patients are competent to drive? Approaches to office-based assessment

David B Hogan. Can Fam Physician. 2005 Mar.

Abstract
in English, French

Objective: To review three proposed approaches to office-based assessment of older drivers and to evaluate recommendations made about dementia and driving.

Quality of evidence: The American Medical Association's (AMA's) Physcian's Guide to Assessing and Counseling Older Drivers gives recommendations for office-based assessment of older patients' medical fitness to drive. Other approaches examined were those outlined in the sixth edition of Determining Medical Fitness to Drive produced by the Canadian Medical Association (CMA) and SAFE DRIVE. Recommendations for dementia and driving from these documents and other sources were reviewed. All evidence was level III.

Main message: The AMA document usefully identified ways to detect drivers at risk and key areas for assessment (vision, cognition, motor function). Recommendations on evaluating these areas require validation. .he CMA guide and SAFE DRIVE were overly broad in their recommendations. How best to detect cognitive impairment that tocld affect driving remains unclear.

Conclusion: Office-based approaches to identifying older drivers who are either unsafe to drive or require more extensive evaluation need to be validated.

OBJECTIF: Passer en revue trois approches proposées pour l’évaluation au bureau des conducteurs âgés et pour examiner les recommandations concernant la démence et la conduite automobile.

QUALITÉ DES PREUVES: Le Physician’s Guide to Assessing and Counseling Older Drivers de l’American Medical Association (AMA) formule des recommandations pour l’évaluation au bureau de l’aptitude à conduire des personnes âgées. Les autres stratégies examinées sont tirées de la sixième édition de Determining Medical Fitness to Drive, une publication de l’Association médicale canadienne (AMC), et de SAFE DRIVE. On a aussi passé en revue les recommandations de ces documents et d’autres sources concernant la démence et la conduite. Toutes les preuves étaient de niveau III.

PRINCIPAL MESSAGE: Le document de l’AMA suggère des façons utiles d’identifier les conducteurs à risque et précise les domaines fonctionnels clés à évaluer (vision, cognition, motricité). Les recommandations sur la façon d’évaluer ces domaines devront toutefois être validées. Les recommandations du guide de l’AMC et de SAFE DRIVE sont jugées trop générales. Ainsi, la façon de bien identifier les déficits cognitifs susceptibles d’affecter la conduite n’y est pas précisée.

CONCLUSION: Les stratégies proposées pour L’identification au bureau des conducteurs âgés qui présentent un danger au volant ou qui requièrent une évaluation supplémentaire devront être validées.

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Conflict of interest statement

Competing interests: None declared

Figures

Figure 1
Figure 1
Patient education handout
See this image and copyright information in PMC

Comment in

  • Fit to drive.
    Irving DW. Irving DW. Can Fam Physician. 2005 Mar;51(3):327-8, 332-3. Can Fam Physician. 2005. PMID: 15794013 Free PMC article. No abstract available.
  • Help assessing seniors' driving.
    Powell C. Powell C. Can Fam Physician. 2005 Jun;51(6):809. Can Fam Physician. 2005. PMID: 15986933 Free PMC article. No abstract available.

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