title: Fitness-to-drive Disagreements in Individuals With Dementia.
abstract: We sought to investigate the agreement between medical and practical fitness-to-drive recommendations in active drivers with dementia.
  
  
  
  In this retrospective study, 68 patients underwent medical, visual, and road tests at an official center of the Belgian Road Safety Institute. Physicians provided medical fitness-to-drive recommendations using 1 of 3 categories (favorable, reserved, or unfavorable). On-road assessors used the same 3 categories to make practical fitness-to-drive recommendations. Agreement between the medical and practical fitness-to-drive recommendations was calculated using the percentage of agreement (p0) and weighted kappa (kw).
  
  
  
  Low agreement was found between physicians and on-road assessors regarding their fitness-to-drive recommendations (p0 = 43%, kw = 0.11, p = .20). Compared with the on-road assessors, the physicians overestimated the fitness to drive of 24 (35%) patients and underestimated the fitness to drive of 15 (22%) patients. Patients who incurred more traffic violations were more likely to be overestimated than underestimated by the physician (p = .03).
  
  
  
  This study showed disagreements between the fitness-to-drive recommendations made by the physicians and the on-road assessors in more than half of drivers with dementia. Efforts need to be made to improve the communication between physicians and on-road assessors for joint decision making of fitness to drive in dementia.
authors: Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Georgia.
authors: Maud
authors: M
authors: Ranchet
authors: CARA, Belgian Road Safety Institute, Brussels, Belgium.
authors: Mark
authors: M
authors: Tant
authors: Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Georgia.|School of Health Professions, The University of Kansas Medical Center.
authors: Abiodun E
authors: AE
authors: Akinwuntan
authors: Movement and Cognitive Disorders Center, Department of Neurology, Augusta University, Georgia.
authors: John C
authors: JC
authors: Morgan
authors: Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Georgia.
authors: Hannes
authors: H
authors: Devos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001333:Automobile Driver Examination; D001334:Automobile Driving / Q000592:standards*; D001530:Belgium; D003704:Dementia / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010820:Physicians; D012189:Retrospective Studies
keywords: Alzheimer’s disease; Decision making; Driving; On-road assessors; Physicians