This document describes: the current legal and notification procedures and clinicians' professional responsibilities relating to health and fitness to drive, with particular reference to the assessment and management of people with cognitive impairment; the scale of the issue in terms of the epidemiology of major conditions causing such impairment; the state of knowledge about the collection of information relevant to fitness to drive using psychological, clinical neuropsychological and driving assessment methods; and research needs, service issues and possibilities for the development of a co-ordinated response to the assessment of people with cognitive impairment. Decision making about fitness to drive in the presence of health problems is the responsibility of the medical advisers at DVLA, UK but they rely heavily on information from general medical practitioners and other health practitioners. Difficulties in accurately assessing fitness to drive, and methods of assessment of driving ability such as driving tests / use of simulators are discussed. A three-stage process for assessment consisting of initial brief screening by relevant health workers, secondary psychological or neuropsychological assessment for cases of intermediate complexity and finally specialist investigation by mobility centres is suggested.
Samenvatting