Conduite automobile et démence : une étude en hôpital de jour gériatrique

With the aging population, physicians are increasingly faced with dementia and the difficulty of assessing the ability of these patients to drive. In a geriatric day hospital, we compared a group of drivers with normal cognitive functions (n = 28) and a group of drivers with dementia (n = 57). Age, sex, antecedents (consciousness loss, diabetes, alcohol consumption), IADL, psychotropic treatment, test of five words and Trail Making Test (TMT) B do not appear as risk factors for road accidents. For “one-leg balance” there is a statistically significant difference between healthy drivers (89.3% success), demented drivers (62.5% success) and demented patients who have stopped driving (17.6% success, P < 0.0001). Our study highlights an increased risk of road accidents in patients with early dementia (MMS ≥ 21). The cessation of driving should be envisaged in the early stages of the disease. However, the consequences of that decision must be taken into account. A multidisciplinary assessment is necessary. These results highlight the value of balance evaluation in addition to cognitive assessment. Present research is towards developing appropriate evaluation methods, without stigmatizing the elderly.