Systematic review of the optimal frequency of follow-up in persons with mild dementia who continue to drive.

Fitness-to-drive guidelines commonly indicate that persons with mild dementia may be safe to drive but that periodic reevaluation is required. This paper presents the findings of a systematic review of primary evidence regarding the optimal timing of follow-up in persons with mild dementia who continue to drive. A search of Medline, CINAHL, PsychInfo, AARP Ageline, and Sociofile from 1984 to 2005 was performed. No published studies focus primarily on the timing of follow-up of drivers with mild dementia. Three studies present longitudinal data that the authors reference when recommending periodicity of follow-up. This study identifies a concerning research gap in the field of dementia and driving. To provide better evidence to guide recommendations for periodicity of follow-up, 3 recommendations are proposed: (1) that prospective cohort driving research be undertaken to follow patients with mild dementia who continue to drive, (2) that data from such longitudinal research be presented as survival analyses, and (3) that existing research on the progression rates of Alzheimer disease be employed as a default until the first 2 recommendations are realized.