title: Assessment and Reporting of Driving Fitness in Patients with Dementia in Clinical Practice: Data from SveDem, the Swedish Dementia Registry.
abstract: Driving constitutes a very important aspect of daily life and is dependent on cognitive functions such as attention, visuo-spatial skills and memory, which are often compromised in dementia. Therefore, the driving fitness of patients with dementia needs to be addressed by physicians and those that are deemed unfit should not be allowed to continue driving.
  
  
  
  We aimed at investigating to what extent physicians assess driving fitness in dementia patients and determinant factors for revoking of their licenses.
  
  
  
  This study includes 15113 patients with newly diagnosed dementia and driver's license registered in the Swedish Dementia Registry (SveDem). The main outcomes were reporting to the licensing authority and making an agreement about driving eligibility with the patients.
  
  
  
  Physicians had not taken any action in 16% of dementia patients, whereas 9% were reported to the authority to have their licenses revoked. Males (OR = 3.04), those with an MMSE score between 20-24 (OR = 1.35) and 10-19 (OR = 1.50), patients with frontotemporal (OR = 3.09) and vascular dementia (OR = 1.26) were more likely to be reported to the authority.
  
  
  
  For the majority of patients with dementia, driving fitness was assessed. Nevertheless, physicians did not address the issue in a sizeable proportion of dementia patients. Type of dementia, cognitive status, age, sex and burden of comorbidities are independent factors associated with the assessment of driving fitness in patients with dementia. Increased knowledge on how these factors relate to road safety may pave the way for more specific guidelines addressing the issue of driving in patients with dementia.
authors.affiliation: Alzheimer's Disease Research Center, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Joel
authors.initials: J
authors.lastname: Lovas
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden.|Department of Neurology and Neurosurgery, McGill University, Montreal General Hospital, Montreal, PQ, Canada.
authors.forename: Seyed-Mohammad
authors.initials: SM
authors.lastname: Fereshtehnejad
authors.affiliation: Alzheimer's Disease Research Center, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.|International Clinical Research Center and St.Anne's University Hospital, Brno, Czech Republic.
authors.forename: Pavla
authors.initials: P
authors.lastname: Cermakova
authors.affiliation: Traffic Medicine Centre, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Catarina
authors.initials: C
authors.lastname: Lundberg
authors.affiliation: Traffic Medicine Centre, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Johansson
authors.affiliation: Traffic Medicine Centre, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Kurt
authors.initials: K
authors.lastname: Johansson
authors.affiliation: Alzheimer's Disease Research Center, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.|Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Winblad
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden.|Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Eriksdotter
authors.affiliation: Alzheimer's Disease Research Center, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.|Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.|Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Religa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D000073216:Mental Status and Dementia Tests; D011596:Psychomotor Disorders / Q000175:diagnosis* / Q000209:etiology*; D012042:Registries / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology
keywords: Alzheimer’s disease; Dementia; agreement; cognitive status; driving license; frontotemporal dementia