Deciding on driving cessation and transport planning in older drivers with dementia

As a result of a significant amount of research in the last two decades, geriatricians have now a much clearer view of the assessment of driving and transport for those with dementia. The most radical underlying conceptual shifts have been: (a) a better balance between the important goals of mobility and safety, and (b) an awareness of the limitation of cognitive approaches to driving ability, and of the need to develop better approaches based on function and behaviour. Building on Comprehensive Geriatric Assessment, useful information can be determined by the multidisciplinary team, but the availability of on-road testing is critical to appropriate assessment of driving in those with dementia. The development of both present and future planning of driving and transport should be viewed as a collaborative process with patients and their families.