[Fitness to drive: legal context and new opportunities for cognitive assessment]

Decisions regarding driving licence eligibility represents a complex medical and legal challenge, requiring careful consideration of both public safety and individual interests. The present paper provides a brief overview of the legal and administrative framework of fitness-to-drive evaluation, the roles of the professionals involved in the process, and key issues related to cognitive assessment. While physical symptoms associated with neurological conditions are generally objectively identifiable, cognitive impairments often remain less apparent and may significantly affect driving ability even in milder forms. The diagnostic accuracy of currently used neuropsychological tests is moderate, which limits the reliability of clinical decision-making. In this context, we present a prospective study conducted in stroke patients, in which a validated model based on the combination of multiple neuropsychological tests and logistic regression was developed. The model explicitly accounts for uncertainty and does not enforce categorical decisions in all cases, thereby allowing clinicians to refrain from definitive judgement in borderline cases. Although the method was validated in a stroke population, the proposed approach may be extended in future research to larger populations, such as older drivers. This would require the selection and validation of age-specific cognitive tests, which may support decision-making already at the level of primary care. Orv Hetil. 2026; 167(28): 1097-1104.