Dalhousie University


Research / Projects
Dementia and Driving Cessation Initiative

Principle Investigator: Dr. Paige Moorhouse, MD, MPH


Currently in Nova Scotia, over 5,000 people with Alzheimer’s disease (AD) continue to drive.

Due to population aging, by the year 2030 one in every 25 drivers over the age of 65 will have dementia.

Alzheimer’s disease impacts driving by:

  • Affecting attention
  • Reaction time
  • Judgment, and
  • Coordination.

Although some people with AD are safe drivers, even the mild to moderate stages of the disease carry a significantly increased risk of motor vehicle crash, with consequences for safety of the driver, passenger,and community.

Many people stop driving after being diagnosed, but of those who continue to drive, almost one half will have a motor vehicle crash in the first five years following their diagnosis.

One of the foremost public health dilemmas surrounding driving safety is how to promote the independence of safe drivers while facilitating driving cessation in those with dementia who are no longer safe to drive.

People with AD often have limited insight into their own driving limitations and may be reluctant to stop driving when recommended by a physician. Family members (especially female caregivers) may perpetuate unsafe driving by agreeing to act as a copilot.

This problem is compounded by the fact that in Nova Scotia, no formal training programs for assessment of fitness-to-drive in dementia have been integrated into medical school curricula, nor is there a failsafe test to predict which individuals with Alzheimer’s disease are at significant risk of motor vehicle crash.

The Canadian Medical Association (CMA) recently issued revised guidelines for the assessment of driving in dementia, which is designed to provide a unified physician approach to assessing fitness to drive in people with dementia; however, this guideline does not offer conclusive answers for case-by-case usage. 

All but three Canadian provinces (including Nova Scotia) require physicians to report potentially unsafe drivers to provincial licensing authorities.  The lack of formal training, absence of a conclusive clinical fitness-to-drive evaluation and current status of discretionary reporting, may all contribute to primary care physician’s lack of confidence in assessing and reporting fitness to drive, highlighting the need for physician education and further resource development.

Current Work

This project involves two phases to address driving cessation in dementia.

Phase one will involve development of a 30-second television public service announcement (PSA) about driving safety in AD.

The PSA will aim to increase awareness of the problem and help female caregivers to understand they can help facilitate the transition to driving cessation.

The PSA is anticipated to lead to an increase in caregiver requests for primary care physicians to discuss driving cessation.

Phase two will involve development of a website designed for primary care physician use. The website will consist of in-office tools and forms, as well as Nova Scotia specific links to community resources and relevant materials.

Resources will also be available to caregivers, as well as other stakeholder groups and healthcare professionals to provide education to patients and family members.

Further Information

Driving and Dementia: Who is safe and who is not?

If you have any questions, please contact the study co-ordinator,
Laura Hamilton
Tel: (902) 473-7295
Email: laura.hamilton@cdha.nshealth.ca



Dalhousie University Faculty of Medicine