To drive or not to drive: preliminary results from road testing of patients with dementia.

There has been considerable debate about whether driving privileges should be revoked from patients with a diagnosis of dementia and whether highway safety policies should come under closer scrutiny for all elderly. Two case studies are reported of patients with a diagnosis of probable Alzheimer's disease who participated in a pilot project to assess driving. Subjects underwent neurologic and neuropsychological evaluation. Caregivers were included in psychosocial assessments. Patients participated in a specially designed driving evaluation, including an actual road test. Although both patients had mild-to-moderate cognitive impairment on standard tests, one of the patients was deemed safe to drive on the road test while the other was not. These preliminary results suggest that driving skill may not be predictable solely on the basis of the office examination. A road competency test provides a more objective and direct measure on which to base a decision of such important consequence. Implications for public policy and the role for healthcare providers in this process are discussed.