Fitness-to-drive Disagreements in Individuals with Dementia

  • Published: Oxford University Press on behalf of The Gerontological Society of America, August 2016
  • Authors: Ranchet, M. Tant, A. E. Akinwuntan, J. C. Morgan and H. Devos
  • Date Added: 02 Jun 2017
  • Last Update: 02 Jun 2017
  • Format: html

Objectives:

To investigate the agreement between medical and practical fitness-to-drive recommendations in active drivers with dementia.

Methodology:

Retrospective study. 68 patients underwent medical, visual, and road tests at an official centre of the Belgian Road Safety Institute. Physicians provided medical fitness-to-drive recommendations using 1 of 3 categories (favourable, reserved, or unfavourable). 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).

Key Findings:

  • 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)

  • Implications: 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.

Themes:

Driving, On-road assessors, Physicians, Stroke

Priced