Driving Skills and Mild Dementia Duchek JM, Carr DB, Hunt L, et al: Longitudinal driving performance in early stage dementia of the Alzheimer type. J Am Geriatr Soc 2003;51(10):1342-47.

Previous studies have reported a relationship between impaired driving abilities and dementia of the Alzheimer type, but not all individuals with mild or very mild dementia are unsafe drivers. In this study, 58 healthy controls (mean age 77) and 50 participants with mild or very mild dementia (mean age 74) were administered a standardized on-road driving assessment every 6 months over a 2-year period. Dementia was staged, using the Clinical Dementia Rating (CDR) scale, as mild (CDR=1) or very mild (CDR=0.5).

At the time of initial testing, 41% of subjects with mild dementia, 14% with very-mild dementia, and 3% of the control subjects were considered unsafe drivers and did not return for testing. Baseline age was a significant risk factor for receiving a rating of not safe, even within the healthy control group. After repeated times of testing, some individuals with very mild dementia and a few with mild dementia appeared to retain safe driving skills. The authors suggest that the guidelines from the Quality Standards Subcommittee of the American Academy of Neurology may be too restrictive because they advise that all individuals with mild dementia or greater should stop driving. Overall, these study findings support guideline advice that driving evaluations need to be conducted every 6 months for drivers with very mild and mild dementia of the Alzheimer's type.