Allan Charlotte L, Behrman Sophie, Baruch Nina, Ebmeier Klaus P
Centre for the Health of the Elderly, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle, UK.
Department of Psychiatry, University of Oxford, Oxford, UK.
Evid Based Ment Health. 2016 Nov;19(4):110-113. doi: 10.1136/eb-2016-102485. Epub 2016 Oct 20.
Most people with mild dementia can continue to drive, but dementia is progressive and many patients and clinicians will be faced with questions about driving safety in the course of their illness. Determining when this happens is a complex decision, with risks of personal and public safety needing to be weighed against individual patient benefits of driving in terms of autonomy, independence and well-being. Decisions need to make reference to cognitive abilities, as well as other factors including physical comorbidity, vision, mobility, insight and history of driving errors and accidents. Deciding to stop driving, or being required to stop driving is often difficult for patients to accept and can be a particularly problematic consequence of a dementia diagnosis. Legal frameworks help in decision-making but may not provide sufficient detail to advise individual patients. We review the current guidelines and evidence relating to driving and dementia to help clinicians answer questions about driving safety and to consider the full range of assessment tools available.
大多数轻度痴呆患者可以继续开车，但痴呆是进行性的，许多患者和临床医生在其病程中会面临有关驾驶安全的问题。确定何时会出现这种情况是一个复杂的决定，需要权衡个人和公共安全风险与患者在自主性、独立性和幸福感方面驾驶的个人益处。决策需要参考认知能力，以及其他因素，包括身体合并症、视力、行动能力、洞察力以及驾驶失误和事故史。决定停止驾驶，或被要求停止驾驶，患者通常难以接受，并且可能是痴呆症诊断带来的一个特别棘手的后果。法律框架有助于决策，但可能没有提供足够的细节来为个体患者提供建议。我们回顾了当前与驾驶和痴呆相关的指南和证据，以帮助临床医生回答有关驾驶安全的问题，并考虑现有的各种评估工具。
