When in the course of dementia should driving stop?

Answer:

Upon diagnosis?

Early literature supported the idea that all people with dementia should stop driving upon diagnosis. However, further research has shown that driving cessation can be associated with poor health outcomes including depression (Marottoli, 2000), caregiver burden, impaired access to health and social programs, and increased risk of admission to a long-term care facility. (Freeman, 2006) In order to maximize health, we must strike a balance between the risks and benefits of driving with dementia.

Progression beyond mild stage dementia?

The risk of MVC is known to increase with progression beyond mild stage dementia (Fox et al., 1997, Hunt et al., 1993) however, progression rates vary between individuals and different physicians may conceptualize the stages of dementia differently.

Based on individualized assessment?

This is the approach recommended by the Canadian Medical Association (CMA) and the 3rd Canadian Consensus Conference on the Diagnosis and Treatment of Dementia. However, neither guideline provides specific advice on decision making for individual patients. This online resource provides a decision support tool to help guide physicians in the assessment of fitness to drive in dementia.