The older driver: a handy tool to assess competence behind the wheel

Predicting with certainty which older patient will have driving problems is not possible, as standardized guidelines do not exist. In the absence of guidelines, the mnemonic SAFE DRIVE outlined in this article can help you identify important risk factors for unsafe driving. Risk factors included in SAFE DRIVE are problems with vision and reaction time, intellectual impairment, a poor safety record, alcohol abuse, use of certain medications, poor attentional skills, impaired executive functions, and a family report of driving problems. Most of these factors can be identified with a careful history, physical examination, in-office tests of cognitive function and alcohol use, and an interview with family member(s).