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J Am Geriatr Soc. 1997 Aug;45(8):949-53.

Alzheimer's disease and driving: prediction and assessment of driving performance.

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1
Rehabilitation Studies Unit, University of Sydney, Royal Rehabilitation Centre Sydney, Ryde, New South Wales, Australia.

Abstract

OBJECTIVES:

To examine driving competence in a group of drivers diagnosed with probable Alzheimer's Disease (AD) in terms of a standardized open road evaluation and expert judgments. To examine the validity of a standardized medical examination, including administration of the Mini-Mental Status Exam (MMSE), and a standardized neuropsychological assessment as predictors of open road driving performance.

DESIGN:

A prospective investigation with consecutively referred subjects.

SETTING:

Coorabel Driver Assessment Centre, Royal Rehabilitation Centre Sydney, Australia.

PARTICIPANTS:

Nineteen subjects with a diagnosis of probable AD.

MEASUREMENTS:

A standardized clinical medical examination, a standardized neuropsychological assessment, and a standardized open road driving evaluation. The driving evaluation provided a correct driving actions score. The outcome measure was the expert judges' rating of overall driving competence, which was termed the final on-road result.

RESULTS:

Seven subjects passed the on-road driving evaluation, and 12 failed. MMSE was found to be a significant predictor of final on-road result. The physician's prediction, the neuropsychology test scores, and the neuropsychologist's prediction were not found to be significantly associated with the final on-road result. The on-road driving evaluation was a reliable test.

CONCLUSION:

Inasmuch as all subjects except one were still driving and all wished to continue to drive, it is important to note that 63.2% of subjects failed the on-road evaluation. Conversely, 36.8% were judged safe to drive, suggesting that AD diagnosis alone may be insufficient criteria for cessation of driving. A standardized road test may be the only appropriate means of determining driving competence in people diagnosed with AD.

PMID:
9256847
[Indexed for MEDLINE]
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