[Dementia and driving]

For most people driving is essential for mobility to maintain independence and to take part in activities of daily living. Ageing per se does not impair driving but in cases of medical conditions, such as cognitive impairment and dementia, driving safety can be impaired. Thus clinicians are often called upon to counsel patients and to make recommendations on their fitness to drive. Dementia in the early stages of the illness does not necessarily preclude driving ability. Patients with mild dementia pose a risk with respect to traffic safety and an individual assessment with regular follow-up investigations should be made. Especially patients with frontotemporal dementia should cease driving early in the course of the disease. Screening tests that focus on visuospatial abilities, attention and executive functions can improve the prediction of driving ability in patients with dementia. In many cases an on-road driving test to evaluate the ability to compensate for functional impairments is essential. In order to preserve personal autonomy as long as possible patients should be individually counselled taking into account driving experience, insight into functional impairments, personality and the capability to compensate for functional disabilities.