Current Evidence for Assessing Fitness to Drive of People with Cognitive Impairment: A Systematic Review

Abstract

Background Assessment of driving ability in people with cognitive impairment is a topic of great social relevance due to the high prevalence of dementia. Methods A comprehensive systematic literature review was conducted on the research question, Which evidence-based methods are suitable for assessing the fitness to drive of people with dementia or mild cognitive impairment? for the period 2015-2020. The search was conducted in the Medline, PsycINFO, LIVIVO, PubPsych, Scopus, Cinahl, and CENTRAL databases. Results Thirty studies were included in the qualitative analysis. Driving ability can be assessed with practice-based testing procedures such as On-road Driving, Simulator, and Naturalistic Driving. Theory-based methods include neuropsychological testing, driving-specific testing, and self-assessment questionnaires. Studies show that single neuropsychological tests are not sufficient to determine fitness to drive. Practice-based test procedures, driving-specific tests, and combinations of evidence-based methods have a higher informative value. Conclusions In view of the progressive course of dementia, the assessment of driving ability of people with cognitive impairment should be performed in a close-meshed way by a combination of theory- and practice-based methods.