## 7 Discussion  
This scoping review included 40 studies that examined the driving performance of individuals with dementia and cognitive impairment. These studies consisted of driving records, experimental driving studies (both simulated and naturalistic), driving rehabilitation programs, safety questionnaires, interviews, and systematic reviews. The findings identified a total of 22 common on-road risks, with the 5 most common risks being speed compliance, getting lost/unfamiliar routes, turning and the use of turn signals, lane adherence and maintenance, and the failure to stop. These risks may be compounded when certain tasks identified as requiring fast decision-making, such as changing routes, switching lanes, overtaking, checking blind spots, monitoring speed, and braking, are involved [18]. Most of the risks were identified in naturalistic driving studies, which was expected as on-road driving assessments are the gold standard to determine one's fitness to drive [19; 20]. One review investigated the cognitive domains associated with poor driving performance or the unfitness to drive by examining studies that measured the outcomes in patients with cognitive impairment or AD using a simulator or on-road driving [6]. The cognitive domains identified by that review, which are frequently reported with unsafe driving and driving cessation for older adults with cognitive impairment or AD, were consistent with the cognitive skills identified in our scoping review [5; 6; 7]. Our team summarized that the cognitive skill deficits mainly contributing to such risks relate to attentional capacity, processing speed, visual-spatial, executive functioning, and memory. It is well established in the literature that drivers with dementia experience cognitive changes that impact their fitness to drive, leading to unsafe driving or driving cessation [18]. This scoping review identified specific on-road risks that may contribute to this unsafe driving thus leading to cessation. Our next step was to relate these specific risks identified in the literature with the use case categories identified by [PERSON] and colleagues [21]. Describing our findings in terms of the use case categories allowed us to see our results from the perspective of overarching themes for accessible mobility. We also related the specific risks to the level of automation that could address the risk. Finally, we also identified current technology that could support drivers with dementia to better manage the identified risks. This final step was included to expand the scope of driving-based technology in mitigating these risks, potentially delaying the cessation of driving for this population. One specific driving-based technology to consider is semi-autonomous and fully automated vehicles. The Society of Autonomous Engineers (SAE) defines six levels of driving automation as follows [22]. In Figure 7, we have depicted each level in concentric circles and mapped the identified driving risks in our review (using arrows within the circle) to be potentially mitigated through increasing levels of driving automation. Level 0 (no driving automation) does not include any autonomous technology, requiring the driver to be fully engaged in operating the vehicle at all times. However, some Level 0 vehicles provide warnings or alerts to notify drivers of potential risks. Level 1 (driver assistance) provides continuous assistance with lateral or longitudinal control (steering or braking/accelerating), allowing for adaptive cruise control or lane-keeping assistance. Level 2 (partial driving automation) provides assistance with both lateral and longitudinal control. Level 3 (conditional driving automation) vehicles can perform lateral and longitudinal driving tasks in specific situations, and the system now also handles environmental monitoring; however, the driver must be available to take control if the system requests assistance or stops functioning effectively.