Dementia is a growing concern worldwide in an ageing population characterised by cognitive decline thereby impacting on daily life activities (Alzheimer’s Disease International, 2017). Individuals with dementia often have little insight regarding driving skills or the need to give up driving for safety reasons.

Visual processing, which is important for hazard perception, can be affected during the early stages of dementia (Begde et al., 2024). Current mainstream methods for assessing fitness to drive do not address important visual processing abilities such as eye-scanning and loss of peripheral vision.

The purpose of this study was to develop a process to identify poor visual processing in those in the early stages of dementia and the impact this has on safe driving. It was intended that the outcomes could facilitate the development of guidelines for identifying fitness to drive in individuals who have a mild cognitive impairment in the early stages of dementia.

This study had the following aims:
• To develop a reliable test of fitness to drive based on visual scanning behaviour for individuals with early-stage cognitive impairment in early dementia
• To develop a process of feedback to drivers who are shown to be no longer to drive safely based on the test developed in the project

Several activities were undertaken both in the UK and Australia.

First, a literature review was carried out to identify previous studies relating to cognitive and visual skills including visual perception in driving and how this is impacted for people in the early stages of dementia. In addition, a method called ‘walking-talking interview’ was used with participants who took part in study 1 (N= 20). This investigated the participants’ opinions about next steps if testing revealed safety concerns with their driving.

A second study carried out in Victoria, Australia was designed to apply the findings of Study 1 in a driving context. It examined the responses of older adults (N=49) with and without mild cognitive impairment to a range of events while driving in a simulated environment using hazard perception testing and eye-tracking.

Finally, all results were reviewed, and a set of recommendations were made for future fitness to drive assessments and stopping driving conversations. These are described further in this presentation.

Professor Andrew Morris, Loughborough University

Professor Andrew Morris is the Director of the Transport Safety Research Centre at Loughborough University, UK.

Andrew has over 35 years’ experience in research into transport safety, vehicle safety, crash investigation, crash injury and driver behaviour research and has published over 320 refereed technical publications, reports and conference papers on the subject of transport safety, crash research, injury prevention and driver behaviour.

Andrew was awarded the US Government Special Award of Appreciation in recognition of outstanding leadership and special contributions in the field of motor vehicle safety (June 2009).