Objectives: To determine whether persons with dementia are at greater driving risk and, if so, to estimate the magnitude of this risk and determine whether there are efficacious methods to compensate for or accommodate it.
Design: Systematic review of the literature.
Setting: Case-control studies.
Participants: Drivers with a diagnosis of dementia.
Measurements: Most studies used state and caregiver reported crash rates, performance-based road tests, and driving simulator evaluations as their outcome measures.
Results: Twenty-three studies were included. Drivers with dementia universally exhibited poorer performance on road tests and simulator evaluations, although only one study using an objective measure of motor vehicle crashes was able to show that drivers with dementia were involved in more crashes than control subjects. No studies were found that examined the efficacy of methods to compensate for or accommodate their worse driving performance.
Conclusion: Drivers with dementia are poorer drivers than cognitively normal drivers, but studies have not consistently demonstrated higher crash rates. Clinicians and policy makers must take these findings into account when addressing issues pertinent to drivers with a diagnosis of dementia.