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Journal Article

Citation

Iverson DJ, Gronseth GS, Reger MA, Classen S, Dubinsky RM, Rizzo M. Neurology 2010; 74(16): 1316-1324.

Affiliation

Humboldt Neurological Medical Group, Inc., Eureka, CA; Department of Neurology, University of Kansas, Kansas City; National Center for Telehealth and Technology, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Tacoma, WA; Occupational Therapy Department, University of Florida, Gainesville; and Department of Neurology, University of Iowa, Iowa City.

Copyright

(Copyright © 2010, Lippincott Williams and Wilkins)

DOI

10.1212/WNL.0b013e3181da3b0f

PMID

20385882

PMCID

PMC2860481

Abstract

OBJECTIVE: To review the evidence regarding the usefulness of patient demographic characteristics, driving history, and cognitive testing in predicting driving capability among patients with dementia and to determine the efficacy of driving risk reduction strategies. METHODS: Systematic review of the literature using the American Academy of Neurology's evidence-based methods. Recommendations: For patients with dementia, consider the following characteristics useful for identifying patients at increased risk for unsafe driving: the Clinical Dementia Rating scale (Level A), a caregiver's rating of a patient's driving ability as marginal or unsafe (Level B), a history of crashes or traffic citations (Level C), reduced driving mileage or self-reported situational avoidance (Level C), Mini-Mental State Examination scores of 24 or less (Level C), and aggressive or impulsive personality characteristics (Level C). Consider the following characteristics not useful for identifying patients at increased risk for unsafe driving: a patient's self-rating of safe driving ability (Level A) and lack of situational avoidance (Level C). There is insufficient evidence to support or refute the benefit of neuropsychological testing, after controlling for the presence and severity of dementia, or interventional strategies for drivers with dementia (Level U).


Language: en

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