The evaluation of medical fitness to drive in patients with dementia, post-stroke conditions, or seizures

<p dir="ltr">Safe automobile driving requires sufficient vision, cognition, and physical capability that, in turn, depend on the relative integrity of cerebral functioning. Fairly common medical conditions such as dementia, stroke, and seizures affect the brain, and may therefore com...

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Main Author: Catarina Lundberg (19524565) (author)
Published: 2015
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author Catarina Lundberg (19524565)
author_facet Catarina Lundberg (19524565)
author_role author
dc.creator.none.fl_str_mv Catarina Lundberg (19524565)
dc.date.none.fl_str_mv 2015-11-12T09:00:00Z
dc.identifier.none.fl_str_mv 10.5339/jlghs.2015.itma.84
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/The_evaluation_of_medical_fitness_to_drive_in_patients_with_dementia_post-stroke_conditions_or_seizures/27175449
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Health sciences
Allied health and rehabilitation science
Public health
Safe Driving
Cognitive Impairment
Medical Conditions
Dementia
Stroke
dc.title.none.fl_str_mv The evaluation of medical fitness to drive in patients with dementia, post-stroke conditions, or seizures
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p dir="ltr">Safe automobile driving requires sufficient vision, cognition, and physical capability that, in turn, depend on the relative integrity of cerebral functioning. Fairly common medical conditions such as dementia, stroke, and seizures affect the brain, and may therefore compromise safe driving. Evidence of unsafe or impaired driving in these diagnostic groups has been presented, but has also been subject to debate. Furthermore, legislation regarding license holding for people with different medical conditions varies widely across countries and states. Nonetheless, it is important, in the clinical context, to determine whether patients should drive, when their medical conditions may put them or other road-users at risk. When patients with dementia and post-stroke conditions are not evidently either fit or unfit to drive, assessments should ideally be carried out by multi-professional teams comprising physicians, neuropsychologists, and/or occupational therapists. Areas addressed should be visual functioning, cognition (with an examination of domains such as attention, speed, and visuospatial ability), and the ability to handle the vehicle. It is also necessary to consider additional factors such as medication use, the presence of co-morbidities and risk of recurrence of stroke, and the risk or speed of progression that makes it necessary to reexamine the patient at suitable intervals (in cases of dementia, at least on a yearly basis). Professionals should be aware of the fact that there is no perfect ‘golden standard’ against which to compare the outcome of the clinical examinations and that factors such as the occurrence of adverse traffic events or the compensatory potential of the individual patient, based on insight and/or premorbid driving skill, should be taken into consideration. Losing consciousness while driving constitutes a considerable traffic hazard, but there is no clear-cut evidence that drivers with epilepsy or seizures are over-represented in motor vehicle crashes. Legislators in different countries have differing approaches to the granting of driving privileges to patients who have had seizures and the required duration of a seizure-free period before driving can be resumed can vary considerably on grounds that do not appear to be scientifically based.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: Journal of Local and Global Health Science, title discontinued as of (2017)<br>License: <a href="https://creativecommons.org/licenses/by/4.0/deed.en" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.5339/jlghs.2015.itma.84" target="_blank">https://dx.doi.org/10.5339/jlghs.2015.itma.84</a></p>
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oai_identifier_str oai:figshare.com:article/27175449
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spelling The evaluation of medical fitness to drive in patients with dementia, post-stroke conditions, or seizuresCatarina Lundberg (19524565)Biomedical and clinical sciencesClinical sciencesHealth sciencesAllied health and rehabilitation sciencePublic healthSafe DrivingCognitive ImpairmentMedical ConditionsDementiaStroke<p dir="ltr">Safe automobile driving requires sufficient vision, cognition, and physical capability that, in turn, depend on the relative integrity of cerebral functioning. Fairly common medical conditions such as dementia, stroke, and seizures affect the brain, and may therefore compromise safe driving. Evidence of unsafe or impaired driving in these diagnostic groups has been presented, but has also been subject to debate. Furthermore, legislation regarding license holding for people with different medical conditions varies widely across countries and states. Nonetheless, it is important, in the clinical context, to determine whether patients should drive, when their medical conditions may put them or other road-users at risk. When patients with dementia and post-stroke conditions are not evidently either fit or unfit to drive, assessments should ideally be carried out by multi-professional teams comprising physicians, neuropsychologists, and/or occupational therapists. Areas addressed should be visual functioning, cognition (with an examination of domains such as attention, speed, and visuospatial ability), and the ability to handle the vehicle. It is also necessary to consider additional factors such as medication use, the presence of co-morbidities and risk of recurrence of stroke, and the risk or speed of progression that makes it necessary to reexamine the patient at suitable intervals (in cases of dementia, at least on a yearly basis). Professionals should be aware of the fact that there is no perfect ‘golden standard’ against which to compare the outcome of the clinical examinations and that factors such as the occurrence of adverse traffic events or the compensatory potential of the individual patient, based on insight and/or premorbid driving skill, should be taken into consideration. Losing consciousness while driving constitutes a considerable traffic hazard, but there is no clear-cut evidence that drivers with epilepsy or seizures are over-represented in motor vehicle crashes. Legislators in different countries have differing approaches to the granting of driving privileges to patients who have had seizures and the required duration of a seizure-free period before driving can be resumed can vary considerably on grounds that do not appear to be scientifically based.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: Journal of Local and Global Health Science, title discontinued as of (2017)<br>License: <a href="https://creativecommons.org/licenses/by/4.0/deed.en" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.5339/jlghs.2015.itma.84" target="_blank">https://dx.doi.org/10.5339/jlghs.2015.itma.84</a></p>2015-11-12T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.5339/jlghs.2015.itma.84https://figshare.com/articles/journal_contribution/The_evaluation_of_medical_fitness_to_drive_in_patients_with_dementia_post-stroke_conditions_or_seizures/27175449CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/271754492015-11-12T09:00:00Z
spellingShingle The evaluation of medical fitness to drive in patients with dementia, post-stroke conditions, or seizures
Catarina Lundberg (19524565)
Biomedical and clinical sciences
Clinical sciences
Health sciences
Allied health and rehabilitation science
Public health
Safe Driving
Cognitive Impairment
Medical Conditions
Dementia
Stroke
status_str publishedVersion
title The evaluation of medical fitness to drive in patients with dementia, post-stroke conditions, or seizures
title_full The evaluation of medical fitness to drive in patients with dementia, post-stroke conditions, or seizures
title_fullStr The evaluation of medical fitness to drive in patients with dementia, post-stroke conditions, or seizures
title_full_unstemmed The evaluation of medical fitness to drive in patients with dementia, post-stroke conditions, or seizures
title_short The evaluation of medical fitness to drive in patients with dementia, post-stroke conditions, or seizures
title_sort The evaluation of medical fitness to drive in patients with dementia, post-stroke conditions, or seizures
topic Biomedical and clinical sciences
Clinical sciences
Health sciences
Allied health and rehabilitation science
Public health
Safe Driving
Cognitive Impairment
Medical Conditions
Dementia
Stroke