Patients and relatives desire their physician to give a judgement about driving abilities : a survey by questionnaire on a Dutch memory clinic.

In this study, 100 consecutive patients and 97 accompanying relatives attending the outpatient memory clinic of the Department of Geriatrics of the Jeroen Bosch Ziekenhuis, a Dutch teaching hospital, from October 2005 till December 2005 filled in a standardized questionnaire. This questionnaire contained three questions about how important they value the following statements: I: in case of a somatic disease, a medical specialist should, if necessary, revoke driving privileges; II: in case of a dementia, a medical specialist should, if necessary, revoke driving privileges; and III: a patient is obliged to follow the physician’s advice. The questionnaire offered four possible answers: not important; little important; important and very important. The accompanying relative was asked to answer the same three questions. In addition, the questionnaire contained questions about demographic factors and driving habits. The assessing physician registered the type and severity of the cognitive disorder using the Reisberg Global Deterioriation Scale ranging from 1-7: no dementia (=1) to severe dementia (=7) and registered if he/she found the patient capable to drive. Statistical analysis was performed with SPSS 12.0 for Windows. For statistical analysis, the one-way ANOVA was used. In those who were still driving 17% was diagnosed with dementia. One in three patients were capable to drive according to the physician, but none of the demented patients. In case of a somatic disease and in case of a dementia respectively, 92% and 94% of the patients and in both situations 99% of their relatives valued it at least important that if necessary, a physician declared a prohibition on automobile driving. In the group with patients, 67% thought that one should rare or never have the freedom to ignore the advice of the physician. For the relatives, this percentage was 71%. The analyses showed no significant differences between patients and relatives concerning their opinion whether a medical specialist should revoke driving license in case of a somatic disease or a dementia. No significant differences in the answers to the three different questions were found when comparing patients with some form of dementia, mild cognitive impairment and no cognitive disorder. Patients still driving were found to value the advice of the physician, in case of a somatic disease significantly less important than patients who stopped driving, but in case of a dementia this difference was not significant. In conclusion, the study shows that, if necessary in case of a somatic disease or dementia, almost all patients and their relatives expect a physician to revoke driving privileges. In The Netherlands however, by law, physicians do not have the right to prohibit automobile driving. Therefore, the authors recommend the physician to give an advice about driving abilities and, if necessary, refer to a professional driving instructor for an on-road test.