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Intervention Review

Driving assessment for maintaining mobility and safety in drivers with dementia

  1. Alan J Martin1,*,
  2. Richard Marottoli2,
  3. Desmond O'Neill3

Editorial Group: Cochrane Dementia and Cognitive Improvement Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 29 OCT 2007

DOI: 10.1002/14651858.CD006222.pub2

How to Cite

Martin AJ, Marottoli R, O'Neill D. Driving assessment for maintaining mobility and safety in drivers with dementia. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD006222. DOI: 10.1002/14651858.CD006222.pub2.

Author Information

  1. 1

    Mater Misericoridiae University Hospital, Dept of Medicine for the Older Person, Dublin, Ireland

  2. 2

    Yale University, Division of Geriatrics, New Haven, USA

  3. 3

    Adelaide and Meath Hospital, Dept of Age Related Health Care, Dublin, Ireland

*Alan J Martin, Dept of Medicine for the Older Person, Mater Misericoridiae University Hospital, Eccles Street, Dublin, 7, Ireland.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009


This is not the most recent version of the article. View current version (29 AUG 2013)



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要


Demographic changes are leading to an increase in the number of older drivers: as dementia is an age-related disease, there is also an increase in the numbers of drivers with dementia. Dementia can impact on both the mobility and safety of drivers, and the impact of formal assessment of driving is unknown in terms of either mobility or safety. Those involved in assessment of older drivers need to be aware of the evidence of positive and negative effects of driving assessment. Although cognitive tests are felt by some authors to have poor face and construct validity for assessing driving performance, extrapolating from values in one large-scale prospective cohort study, the cognitive test that most strongly predicted future crashes would, if used as a screening tool, potentially prevent six crashes per 1000 people over 65 screened, but at the price of stopping the driving of 121 people who would not have had a crash.


Primary objectives:
1. To assess whether driving assessment facilitates continued driving in people with dementia
2. To assess whether driving assessment reduces accidents in people with dementia

Secondary objective:
To assess the quality of research on assessment of drivers with dementia.

Search methods

The Cochrane Dementia Group's Specialized Register was searched on 30 October 2007 using the terms: driving or driver* or "motor vehicle*" or "car accident*" or "traffic accident*" or automobile* or traffic. This register contains records from major healthcare databases, ongoing trial databases and grey literature sources and is updated regularly.

Selection criteria

We sought randomized controlled trials prospectively evaluating drivers with dementia for outcomes such as transport mobility, driving cessation or motor vehicle accidents following driving assessment.

Data collection and analysis

Each author retrieved studies and assessed for primary and secondary outcomes, study design and study quality.

Main results

No studies were found that met the inclusion criteria. A description and discussion of the driving literature relating to assessment of drivers with dementia relating to the primary objectives is presented.

Authors' conclusions

In an area with considerable public health impact for drivers with dementia and other road users, the available literature fails to demonstrate the benefit of driver assessment for either preserving transport mobility or reducing motor vehicle accidents. Driving legislation and recommendations from medical practitioners requires further research that addresses these outcomes in order to provide the best outcomes for both drivers with dementia and the general public.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Driving assessment for maintaining mobility and safety in drivers with dementia

The proportion of older people in the world is increasing and consequently the number of older drivers is also on the rise. Older people commonly depend upon private motor vehicles for their transport needs and so assessment of older drivers with cognitive impairment is becoming increasingly important. We have reviewed the literature on driving assessment in people with dementia for two reasons. Firstly, we wished to see if assessment helped people with dementia and good driving skills continue driving. Secondly, we wished to discover whether assessment was useful in preventing road traffic accidents.

Although many authors have studied the motor skills, neuropsychological performance and driving behaviour of drivers with dementia, we found no study that randomized drivers to prospectively evaluate these outcomes following assessment. This highlights the need for caution in applying the literature on driving assessment to clinical settings as no benefit has yet been prospectively demonstrated. It also indicates the need for prospective evaluation of new and existing models of driver assessment to best preserve transport mobility and minimise road traffic accidents.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要



人口統計變化顯示老年駕駛數目增加,失智症是一個與年齡有關的疾病,也因此患有失智症的駕駛者之數目也隨之增加。 失智症會影響駕駛者的移動力及安全性,而就移動性與安全性來說,正式的駕駛能力評估帶來的影響仍不清楚。 那些以老年駕駛者所進行的評估需要注意到駕駛評估的正面及負面效果。 儘管有些作者認為駕駛能力評估有其負面影響,並且覺得建構效度(construct validity)不佳,不過從一個前瞻性世代研究的評價進一步的外推,顯示認知測驗最能預測未來發生衝撞的可能性,若進行篩選,在每1000名65歲以上的老人當中,可以預防 6起衝撞事故,不過代價是有121名事實上不會發生衝撞事故的老人被禁止開車


主要目的: 1. 評估駕駛評估是否促進失智症患者持續駕駛。 2. 評估駕駛評估是否減少失智症患者發生意外。 次要目的: 評估失智症駕駛者研究的品質


2007年10月30日在Cochrane Dementia and Cognitive Improvement Group Specialized Register資料庫使用詞語:driving或driver* 或 “motor vehicle*” 或 “car accident*” 或 “traffic accident*”或automobile*或 traffic進行搜尋。 這資料庫不但含有由主要健康資料庫的記錄也包含許多進行中的臨床試驗資料庫及灰色文獻來源且被規律地更新


選擇標準如下: 採用對照試驗前瞻性,在對失智症駕駛進行駕駛能力測驗過後,評估相關結果,譬如移動力、暫停駕駛、或是車輛事故








此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌


全世界老年人口比例正在增加,因此較年長駕駛者的數目也上升。老年人多依賴私人轎車來滿足其移動的需求,因此對於認知損傷的老年人進行駕駛能力評估亦日趨重要。我們回顧失智患者駕駛能力評估原因有二: 為了兩個理由我們已經評論了失智症人們駕駛評量上的文獻。 首先,我們希望瞭解是否評量能幫助失智症者及良好的駕駛技巧而持續駕駛。 再者,我們期盼能發現是否評量在防止道路交通意外上有所用處。 雖然許多作者已經研究該失智症駕駛者的移動技巧、神經心理上的表現及駕駛行為,但我們發現沒有研究是以隨機分配的駕駛者、前瞻性的在評量後評估這些結果。 這顯示了由於還沒有以前瞻性的方式證實其效益,因此應用駕駛能力文獻於臨床環境時需要小心謹慎。此外也點出了需要前瞻性的評估新進以現有的駕駛能力評估模式,以最佳化維持移動力並且減少道路交通事故