Driving and dementia: dilemmas and decisions.

Dementia may compromise the competence and safety of an older driver. Persons with dementing diseases frequently experience disturbances in memory, language, orientation, visual spatial skills, and the ability to perform complex tasks. Safety cannot be increased by training or modifications to the vehicle, nor can those afflicted be expected to exercise sound judgment. Individuals may become lost on familiar streets, fail to follow directional signs, and drive at inappropriate speeds. This paper will provide an overview of state licensing provisions, physician responsibilities, and a clinical approach to address and manage the driver with dementia.