Determining fitness to drive among drivers with Alzheimer's disease or cognitive decline

Introduction: Fitness to drive skills progressively deteriorate following a diagnosis of Alzheimer’s disease/cognitive decline. Occupational therapists require standardised assessments to help them make recommendations to clients and licensing authorities regarding client fitness to drive. This research aimed to determine whether drivers in the early stages of Alzheimer’s disease/cognitive decline can drive safely, and if this could be predicted using the occupational therapy – driver off-road assessment battery (OT-DORA Battery). Method: Drivers with Alzheimer’s disease/cognitive decline were assessed by one of nine driver assessors over 18 months. Client data were collected on the OT-DORA Battery and following on-road assessment; the outcome was recorded as pass, pass with conditions, or fail. Results: A total of 63 clients were assessed, and n ¼ 40 (63.5%) were passed as fit to drive, of whom 33(83%) had at least one condition placed on their licence. Client age and scores on four subtests of the OT-DORA Battery were predictive of outcome. Conclusion: A diagnosis of Alzheimer’s disease/cognitive decline should not automatically preclude driving. Scores on four of the subtests from the OT-DORA Battery may be used to help determine whether a client is fit to drive or not fit to drive, or whether a client should be referred for specialist occupational therapy driver assessment.