Driving Fitness in Different Forms of Dementia: An Update

Max Toepper, PhD; Michael Falkenstein, MD


J Am Geriatr Soc. 2019;67(10):2186-2192. 

In This Article


To examine the effects of severity and type of dementia on different driving outcomes, we conducted a systematic review with qualitative synthesis in line with the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses.[10]


The population of interest involved older drivers with dementia. Dementia included ADD and non-Alzheimer dementia syndromes, such as VaD, FTD, DLB, and PDD. Different stages of dementia were reviewed, including mild cognitive impairment (MCI).[11,12]

Sources and Search Strategy

Literature search included MEDLINE and PsycINFO databases, with a focus on relevant and recent publications on the topic. Key words included different driving outcomes, such as "driving," "driving performance," "driving fitness," "driving abilities," "driving skills," "driving competence," "driving safety," "accident rates," and "crash risk" in drivers with "mild cognitive impairment," "dementia," "Alzheimer disease dementia," "vascular dementia," "frontotemporal dementia," "dementia with Lewy bodies," and "Parkinson disease dementia." For database search, each of the driving outcomes was combined with each of the syndromes. Both authors also screened the reference lists of relevant reviews and meta-analyses.

Data Extraction and Synthesis

After the deletion of duplicates, both authors screened the abstracts for possibly eligible and relevant publications. Both authors then checked the full-text articles of the remaining publications for eligibility and relevance and extracted the main findings. Thereby, the quality of studies was evaluated in accordance with established guidelines, as proposed by Meltzoff and Cooper.[13] Main findings were then summarized narratively to provide a brief overview of driving fitness in different forms and stages of dementia, resulting in practical implications and policy recommendations.