Objective: Patients with mental illness may have impairment of their driving ability either due to the illness itself, or related to medication being used to treat the illness. Advanced age itself can result in diminished driving safety, and therefore mental illness in the elderly can present a particular problem. Society generally treats driving as a privilege, and reserves the right to limit driving in individuals with impaired ability that would threaten the safety of themselves or others. This paper will review various approaches to regulate driving in persons with mental illness. Primary emphasis will be the discussion of driving in dementia. Driving ability in dementia has been shown to correlate with dementia severity as measured by a variety of clinical rating scales. We will discuss how a society can chose to translate that into regulations and policies that best minimize risk while allowing some persons with dementing illnesses to continue to drive while their excess risk approximates that of other conditions where society allows driving, such as teenage drivers.
Design: A literature review of data pertaining to driving safety in mental illness, and a review of current regulatory approaches to address potentially impaired drivers.
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