Why and how to evaluate driving abilities in patients with neurodegenerative diseases?

Many studies have shown that individuals with neurodegenerative diseases are at risk of being involved in a traffic accident. However, driving is critical for social integration and independence in daily life. The lack of consensus and a standardised assessment of driving abilities in these patients is problematic. This article summarises the various multidisciplinary evaluations proposed, their limits and the societal issues raised by such an evaluation. Several theoretical neuropsychological models have attempted to describe the cognitive processes involved in car driving. Moreover, several studies into neurodegenerative diseases have sought to determine which alterations to cognitive functions best explain driving errors. In this article, we describe the relationships between neuropsychological performance and driving abilities for the most frequent neurodegenerative disorders. It appears that a full neuropsychological assessment is necessary to accurately determine which patients are at risk of dangerous driving. In particular, cognitive impairments in attention, visual-spatial abilities, executive functions, and/or information processing speed appear to be the most likely to be involved in driving errors.