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Published on: September 18, 2012
Fitness-to-drive Disagreements in Individuals With Dementia
Maud Ranchet1, Mark Tant2, Abiodun E Akinwuntan1,3
1Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Georgia.
Purpose Of The Study:
We sought to investigate the agreement between medical and practical fitness-to-drive recommendations in active drivers with dementia.
Design And Methods:
In this retrospective study, 68 patients underwent medical, visual, and road tests at an official center of the Belgian Road Safety Institute. Physicians provided medical fitness-to-drive recommendations using 1 of 3 categories (favorable, reserved, or unfavorable). On-road assessors used the same 3 categories to make practical fitness-to-drive recommendations. Agreement between the medical and practical fitness-to-drive recommendations was calculated using the percentage of agreement (p0) and weighted kappa (kw).
Results:
Low agreement was found between physicians and on-road assessors regarding their fitness-to-drive recommendations (p0 = 43%, kw = 0.11, p = .20). Compared with the on-road assessors, the physicians overestimated the fitness to drive of 24 (35%) patients and underestimated the fitness to drive of 15 (22%) patients. Patients who incurred more traffic violations were more likely to be overestimated than underestimated by the physician (p = .03).
Implications:
This study showed disagreements between the fitness-to-drive recommendations made by the physicians and the on-road assessors in more than half of drivers with dementia. Efforts need to be made to improve the communication between physicians and on-road assessors for joint decision making of fitness to drive in dementia.
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