Determining When Someone Should No Longer Drive
This is certainly a hot topic, in the wake of Santa Monica's Farmers' Market tragedy. APA provides a brief summary of a meta-analysis published in Neuropsychology looking at ways to assess 'driveability' in those with early stage Alzheimer's.- Tests of visuospatial skills generally related best to driving abilities. They may be most helpful in identifying at-risk drivers, especially as visuospatial deficits are common in early Alzheimer’s and other dementias.
The authors conclude that, “Although visuospatial deficits alone are not sufficient to recommend driving restrictions, the results indicate that when visuospatial deficits are present, clinicians should complete a careful evaluation of other risk factors.” They are a red flag to look for other problems.
Reger et al. were surprised to see that attention and concentration tests may be less helpful than some other tests of functioning. Their effect sizes were significant but not as large as predicted. Also, if clinicians get caregiver reports, they should take into account additional factors to assess risk.
The authors add, “Neuropsychological testing makes a significant contribution to predicting driving ability. However, they do not indicate at what level of impairment a specific patient is unfit to drive.” Further research is needed to determine the right cutoffs.
Check out the article for full details, entitled: “The Relationship Between Neuropsychological Functioning and Driving Ability in Dementia: A Meta-Analysis,” Reger et al., Neuropsychology, Vol. 18, No. 1.
APA