Fitness-to-drive Disagreements in Individuals with Dementia

Maud Ranchet, Mark Tant, Abiodun Emmanuel Akinwuntan, John C. Morgan, Hannes Devos

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose of the Study: We sought to investigate the agreement between medical and practical fitness-to-drive recommendations in active drivers with dementia. Design and Methods: In this retrospective study, 68 patients underwent medical, visual, and road tests at an official center of the Belgian Road Safety Institute. Physicians provided medical fitness-to-drive recommendations using 1 of 3 categories (favorable, reserved, or unfavorable). On-road assessors used the same 3 categories to make practical fitness-to-drive recommendations. Agreement between the medical and practical fitness-to-drive recommendations was calculated using the percentage of agreement (p 0) and weighted kappa (k w). Results: Low agreement was found between physicians and on-road assessors regarding their fitness-to-drive recommendations (p 0 = 43%, k w = 0.11, p =.20). Compared with the on-road assessors, the physicians overestimated the fitness to drive of 24 (35%) patients and underestimated the fitness to drive of 15 (22%) patients. Patients who incurred more traffic violations were more likely to be overestimated than underestimated by the physician (p =.03). Implications: This study showed disagreements between the fitness-to-drive recommendations made by the physicians and the on-road assessors in more than half of drivers with dementia. Efforts need to be made to improve the communication between physicians and on-road assessors for joint decision making of fitness to drive in dementia.

Original languageEnglish (US)
Pages (from-to)833-837
Number of pages5
Issue number5
StatePublished - Oct 1 2017


  • Alzheimer's disease
  • Decision making
  • Driving
  • On-road assessors
  • Physicians

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology


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