Systematic review of driving risk and the efficacy of compensatory strategies in persons with dementia.
OBJECTIVE
To determine whether persons with dementia are at greater driving risk and, if so, to estimate the magnitude of this risk and determine whether there are efficacious methods to compensate for or accommodate it.


METHODS
Systematic review of the literature.


METHODS
Case-control studies.


METHODS
Drivers with a diagnosis of dementia.


METHODS
Most studies used state and caregiver reported crash rates, performance-based road tests, and driving simulator evaluations as their outcome measures.


RESULTS
Twenty-three studies were included. Drivers with dementia universally exhibited poorer performance on road tests and simulator evaluations, although only one study using an objective measure of motor vehicle crashes was able to show that drivers with dementia were involved in more crashes than control subjects. No studies were found that examined the efficacy of methods to compensate for or accommodate their worse driving performance.


CONCLUSIONS
Drivers with dementia are poorer drivers than cognitively normal drivers, but studies have not consistently demonstrated higher crash rates. Clinicians and policy makers must take these findings into account when addressing issues pertinent to drivers with a diagnosis of dementia.
Man-Son-Hing
Malcolm
M
Canadian Institutes of Health Research CanDRIVE Research Program, Elisabeth Bruyere Research Institute, Sisters of Charity Ottawa Health Service, Ottawa, Ontario, Canada. mhing@ohri.ca
Marshall
Shawn C
SC
Molnar
Frank J
FJ
Wilson
Keith G
KG
D000063:Accidents, Traffic / Q000517:prevention & control* / Q000523:psychology*; D001334:Automobile Driving / Q000523:psychology*; D003704:Dementia / Q000523:psychology*; D006801:Humans; D018570:Risk Assessment