These include a perceived breach of personal liberty if a licence is cancelled, restriction in lifestyle for the older patient, demands by the older patient to continue to drive, and threats to the doctor-patient relationship. However, failure to advise a patient with dementia not to drive, failure to document that advice and failure to notify the relevant driver licensing authority may result in injury or death of the patient or of other innocent people. Such failure of patient care and social duty may breach professional ethics and may expose the doctor to legal action. Conclusion Doctors should use a recognised form of cognitive screening to assess all their patients over 70 years who drive. Doctors also need better training in medical driving assessments and diagnosis of early Alzheimer's disease.
More funding is needed for on-road assessment of cognitively impaired drivers.
We need more research into the reliability of medical driver assessments, crash risks and cognitive screening measures, particularly for the very early stages of Alzheimer's disease. 2,13 Rural drivers with dementia who are forced to give up their licences may be particularly at risk of becoming socially isolated, disadvantaged and perhaps stranded. Still, this is still no excuse for allowing an impaired driver to continue driving. References Freidland RP, Kos E, Kumar A, et al. Motor vehicle crashes in dementia of the Alzheimer's type.