Evaluation and management of the driver with dementia

被引:42
作者
Dobbs, BM
Carr, DB
Morris, JC
机构
[1] Univ Alberta, Fac Rehabil Med, Rehabil Res Ctr, Dept Psychol, Edmonton, AB T6G 2E4, Canada
[2] Washington Univ, Sch Med, Dept Neurol, St Louis, MO 63110 USA
[3] Washington Univ, Sch Med, Older Adult Hlth Ctr, St Louis, MO 63110 USA
关键词
dementia; driving; evaluation;
D O I
10.1097/00127893-200203000-00001
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND- The number of older adult drivers with dementia is expected to increase over the next few decades. This increase raises public and personal safety concerns given the higher crash rates of drivers with a dementing illness. However, the identification of drivers with a dementia who may be at risk for a crash is difficult, particularly for those in the early stages of dementia. REVIEW SUMMARY- Studies examining the correlation of dementia with driving outcomes such as motor vehicle crashes are reviewed. The strengths and weaknesses of recent consensus statements, published to assist clinicians in evaluating drivers with a dementia, are discussed. The authors also review common practices currently in use by physicians to identify at-risk drivers, including mental status examinations, global dementia rating scales, specialist referral, medical evaluations, and the use of caregiver reports and other proxy measures. Legal issues, based on the role of the physician, are reviewed along with suggestions for driving cessation and education for the caregiver and family. CONCLUSIONS- In patients with mild to moderate dementia, the literature indicates that physicians would have difficulty in identifying which individuals should not drive. Performance-based measures of driving skills, such as on-road driving tests, are recommended as a means of assessing driving competency.
引用
收藏
页码:61 / 70
页数:10
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