I just passed my driving test!

• I frequently see patients with fairly advanced dementia and confusion who are still driving their motor vehicles and would you believe have just passed the State Government driving test! 

• This is so frustrating for Doctors and patients, and a real challenge for the Doctor to convince these confused older drivers that they are no longer able to drive their motor vehicle despite passing this State Government driving test.

• The over 65 years population are growing faster than  other age groups.  Over 60% of people aged 75 years and over have a driving licence in Australia. I estimate that there are at least 160,000 drivers over 75 years of age on Australian roads with unrecognised dementia!

• These driving tests do not identify cognitive impairment in the older driver. The patient’s lack of insight due to their dementia means that they frequently ignore the medical recommendation and go on to drive, even when their licence has been cancelled.

• Common responses include:

  -      I just passed my driving test.

  -      I only drive to the shops.

  -      I don’t need a licence to drive short distances!

• Unfortunately the State Government Driving Licence test in Australia is a failed system and doesn't have a low enough threshold to detect impaired cognition and dementia in these drivers.

• The bottom line is that State Governments should not be dishing out these driving licences to impaired older drivers. 

• I recommend that all drivers aged 70 and over should have an annual cognitive test ( Mini-Mental exam and MOCA) and visual processing test.  If they don’t get 100% they should be referred to a Geriatrician for further cognitive assessment before they can get their driving licence.

• The clock drawing test, although it is non-specific, is a very good screening test for cognitive impairment and correlates well with dementia.  It is a paradox that drivers with dementia who are unable to draw numbers on a clock face are allowed to drive a car in complex traffic situations, putting themselves and the public at risk.

• Most Doctors would prefer that the State Government Licencing Authority test cognitive function before giving out drivers licences and deal with the issue themselves.

• It should not be up to the Doctor to sort this out, or to be held responsible or to wait for the crisis to occur.

For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.