[Assessment of cognitive suitability to drive after brain injury]

There is an increasing interest in methods for assessing fitness to hold a driver's licence among patients with traumatic brain injury, cerebrovascular accidents and other central nervous system diseases which present cognitive impairments. This article describes a multimodal approach including medical, neuropsychological and open-road evaluations. We also present a study of 135 patients with cognitive deficits, 29 females and 106 males, mean age 48. Data from neuropsychological assessments are compared to scores on the Mini Mental State Examination and to results from the open-road tests. We recommend that patients with Mini Mental State scores > 20 are referred for further neuropsychological assessments, while patients with scores < 20 are usually unfit for driving. We regard the Mini Mental State Examination as unsuited for patients with aphasia. Our recommendation is that patients who present a complicated picture are referred to regional interdisciplinary centres.