Driving and dementia: Efficient approach to driving safety concerns in family practice.

OBJECTIVE: To provide primary care physicians with an approach to driving safety concerns when older persons present with memory difficulties. SOURCES OF INFORMATION: The approach is based on an accredited memory clinic training program developed by the Centre for Family Medicine Primary Care Collaborative Memory Clinic. MAIN MESSAGE: One of the most challenging aspects of dementia care is the assessment of driving safety. Drivers with dementia are at higher risk of motor vehicle collisions, yet many drivers with mild dementia might be safely able to continue driving for several years. Because safe driving is dependent on multiple cognitive and functional skills, clinicians should carefully consider many factors when determining if cognitive concerns affect driving safety. Specific findings on corroborated history and office-based cognitive testing might aid in the physician's decisions to refer for comprehensive on-road driving evaluation and whether to notify transportation authorities in accordance with provincial reporting requirements. Sensitive communication and a person-centred approach are essential. CONCLUSION: Primary care physicians must consider many factors when determining if cognitive concerns might affect driving safety in older drivers.