Practice Parameter: Assessing and Managing Driving Risk in Dementia

The purpose of this American Academy of Neurology practice parameter update (since 2000) was to systematically review the literature for evidence to guide our approach to patients with dementia who drive.

The Clinical Dementia Rating scale (CDR) had the strongest supportive evidence (level A) as a measure to predict impaired driving. Caregiver opinion of unsafe driving was less predictive but its supportive evidence reached level B. All other evidence was level C, including that for crash and citation records, amount and type of driving exposure, Mini-Mental State Examination scores, and impulsive personality traits. Patient self-rating of driving skills clearly was not useful (level A evidence against). The evidence for using comprehensive …