title: Comparison of the SIMARD MD to Clinical Impression in Assessing Fitness to Drive in Patients with Cognitive Impairment.
abstract: BACKGROUND
  The assessment of fitness to drive in patients with cognitive impairment is complex. The SIMARD MD was developed to assist with assessing fitness to drive. This study compares the clinical decision made by a geriatrician regarding driving with the SIMARD MD score.
  
  
  METHODS
  Patients with a diagnosis of mild dementia or mild cognitive impairment, who had a SIMARD MD test, were included in the sample. A retrospective chart review was completed to gather diagnosis, driving status, and cognitive and functional information.
  
  
  RESULTS
  Sixty-three patients were identified and 57 met the inclusion criteria. The mean age was 77.1 years (SD 8.9). The most common diagnosis was Alzheimer's disease in 22 (38.6%) patients. The mean MMSE score was 24.9 (SD 3.34) and the mean MoCA was 19.9 (SD 3.58). The mean SIMARD MD score was 37.2 (SD 19.54). Twenty-four patients had a SIMARD MD score ≤ 30, twenty-eight between 31-70, and five scored > 70. The SIMARD MD scores did not differ significantly compared to the clinical decision (ANOVA p value = 0.14).
  
  
  CONCLUSIONS
  There was no association between the SIMARD MD scores and the geriatricians' clinical decision regarding fitness to drive in persons with mild dementia or mild cognitive impairment.
authors.affiliation: Dalhousie University Medical School, Saint John, NB;
authors.forename: Madelaine
authors.initials: M
authors.lastname: Wernham
authors.affiliation: Department Geriatric Medicine, Horizon Health Network, Saint John, NB;
authors.forename: Pamela G
authors.initials: PG
authors.lastname: Jarrett
authors.affiliation: Department of Computer Science & Applied Statistics, University of New Brunswick, Saint John, NB.
authors.forename: Connie
authors.initials: C
authors.lastname: Stewart
authors.affiliation: Department Geriatric Medicine, Horizon Health Network, Saint John, NB;
authors.forename: Elizabeth
authors.initials: E
authors.lastname: MacDonald
authors.affiliation: Department Geriatric Medicine, Horizon Health Network, Saint John, NB;
authors.forename: Donna
authors.initials: D
authors.lastname: MacNeil
authors.affiliation: Department Geriatric Medicine, Horizon Health Network, Saint John, NB;
authors.forename: Cynthia
authors.initials: C
authors.lastname: Hobbs
keywords: SIMARD MD; clinical decision; dementia; driving; mild cognitive impairment