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Alzheimer’s disease and driving: review of the literature and consensus guideline from Belgian dementia experts and the Belgian road safety institute endorsed by the Belgian Medical Association

  • Consensus paper and Guideline
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Abstract

Alzheimer’s disease (AD) is a highly prevalent condition and its prevalence is expected to further increase due to the aging of the general population. It is obvious that the diagnosis of AD has implications for driving. Finally, driving discussions are also emotionally charged because driving is associated with independence and personal identity. However, it is not clear how to implement this in clinical practice and the Belgian law on driving is rather vague in its referral to neurodegenerative brain diseases in general nor does it provide clear-cut instructions for dementia or AD compared to for example driving for patients with epilepsy and as such does not prove to be very helpful. The present article reviews what is known from both literature and existing guidelines and proposes a consensus recommendation tailored to the Belgian situation agreed by both AD experts and the Belgian Road Safety Institute endorsed by the Belgian Medical Association. It is concluded that the decision about driving fitness should be considered as a dynamic process where the driving fitness is assessed and discussed early after diagnosis and closely monitored by the treating physician. The diagnosis of AD on itself definitely does not imply the immediate and full revocation of a driving license nor does it implicate a necessary referral for a formal on-road driving assessment. There is no evidence to recommend a reduced exposure or a mandatory co-pilot. A MMSE-based framework to trichotomise AD patients as safe, indeterminate or unsafe is presented. The final decision on driving fitness can only be made after careful history taking and clinical examination, neuropsychological, functional and behavioral evaluation and, only for selected cases, a formal assessment of driving performance.

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Author information

Authors and Affiliations

  1. Department of Neurology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Jan Versijpt

  2. CARA Department, Centre for Fitness to Drive, Belgian Road Safety Institute, Brussels, Belgium

    Mark Tant

  3. Geriatric Department, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium

    Ingo Beyer

  4. Department of Neurology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium

    Jean-Christophe Bier

  5. Born Bunge Institute and Antwerp University Hospital, University of Antwerp, Wilrijk, Belgium

    Patrick Cras

  6. Laboratory of Neurochemistry and Behavior, Reference Center for Biological Markers of Dementia, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium

    Peter P. De Deyn & Sebastiaan Engelborghs

  7. Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium

    Peter P. De Deyn & Sebastiaan Engelborghs

  8. Department of Neurology, AZ Sint Jozef, Malle, Belgium

    Patrick De Wit

  9. Department of Neurology, AZ St Jan, Brugge, Belgium

    Olivier Deryck

  10. Department of Neurology, Saint Luc University Clinic and Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium

    Bernard Hanseeuw & Adrian Ivanoiu

  11. Department of Geriatrics, AZ St Jan, Brugge, Belgium

    Margareta Lambert

  12. Afdeling Geriatrie, SILVA Medical, Scheutbos, Brussels, Belgium

    Jean-Claude Lemper

  13. Department of Neurology, Université Catholique de Louvain, CHU UCL Namur, Godinne, Belgium

    Eric Mormont

  14. Institute of Neuroscience (IoNS), UCL, Brussels, Belgium

    Eric Mormont

  15. Department of Internal Medicine (Geriatrics), Ghent University, Ghent, Belgium

    Mirko Petrovic

  16. Department of Neurology and Memory Clinic, Clinique Saint-Pierre, Ottignies, Belgium

    Gaetane Picard

  17. Memory Clinic, Service of Neurology, CHU Liège, Liège, Belgium

    Eric Salmon

  18. Memory Clinic, CHU Brugmann, Brussels, Belgium

    Kurt Segers

  19. Neurology Department, Gent University Hospital, Gent, Belgium

    Anne Sieben & Evert Thiery

  20. Geriatric Medicine and Memory Clinic, University Hospitals Leuven, Leuven, Belgium

    Jos Tournoy

  21. Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium

    Jos Tournoy

  22. Universitair Centrum Geriatrie and ZNA St Elisabeth, Universiteit Antwerpen, Antwerpen, Belgium

    Maurits Vandewoude

  23. Direction Médicale and Services des Neurosciences, Grand Hôpital de Charleroi, Charleroi, Belgium

    Manfredi Ventura

  24. Expertisecentrum Dementie Vlaanderen, Antwerp, Belgium

    Jurn Verschraegen

  25. Ordre des Medicins/Orde der Artsen, Brussels, Belgium

    Tom Goffin & Michel Deneyer

  26. Department of Paediatrics, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium

    Michel Deneyer

Authors
  1. Jan Versijpt
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  2. Mark Tant
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  3. Ingo Beyer
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  26. Adrian Ivanoiu
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Correspondence to Jan Versijpt.

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Versijpt, J., Tant, M., Beyer, I. et al. Alzheimer’s disease and driving: review of the literature and consensus guideline from Belgian dementia experts and the Belgian road safety institute endorsed by the Belgian Medical Association. Acta Neurol Belg 117, 811–819 (2017). https://doi.org/10.1007/s13760-017-0840-5

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  • DOI: https://doi.org/10.1007/s13760-017-0840-5

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