The objective was to assess the performance of patients with dementia on the DRIVAGE semi-realistic driving simulator task. A study of patients with dementia who were continuing to drive a car at the time of assessment, was undertaken in a specialist Pre-Senile Dementia Clinic at The National Hospital for Neurology and Neurosurgery and a driving simulator laboratory at King`s College, London. It comprised thirteen patients diagnosed with dementia (10 Alzheimer's disease, three focal dementia syndrome), mean age 63 (range 57 - 71) years. Measured performance was judged by rater, blind to diagnosiss and neuropsychological test results, as either normal or poor by comparison with data previously collected on 125 normal older drivers. Secondary performance was assessed from objective performance data generated by the simulator. The performance of seven patients was rated as normal and that of six as poor. The majority with poor performance could only complete two of four driving tasks. The normal group scored higher on the Mini Mental State Examination (24 (21-27) versus 17 (13-22)), were less impaired on neuropsychological testing, particularly tasks assessing performance IQ, and had intact perceptual abilities. The results of the study demonstrate that patients with dementia can retain their ability to perform a driving task. Loss of this ability is broadly associated with progression of dementia, impaired perception and impairment of non-verbal intelligence tests. Studies on larger groups of patients in amore comprehensive driving task would be required to demonstrate specific markers of loss of driving ability.
Samenvatting