Assessment of driving ability for neurosurgical disease patients

Abstract

  In parallel with Japan’s ultra‒aging society, traffic accidents involving aged drivers with impaired cognitive function have been becoming more common. Our institute has attempted to determine whether individuals with neurological impairment have sufficient ability to drive a vehicle safely. The Trial Making Test‒A and B (TMT‒A/B) and the Stroke Drivers Screening Assessment (SDSA) have been described as reliable evaluation methods for stroke patients. Here, we assessed the driving ability of 141 patients by the SDSA, TMT‒A and B, and the Hasegawa Dementia Scale‒Revised (HDS‒R) in conjunction with their age, sex, laterality of lesion, disease subtype (including stroke divided into its ischemic vs. hemorrhagic), head trauma, and other diseases. The patients were 100 males and 41 females, mean age 67.1 years. Ninety‒six patients (68.1%) cleared. Of the 119 stroke patients (84.4%), 83 had ischemic and 36 had hemorrhagic subtypes. A univariate analysis including age, HDS‒R, and TMT‒A and B scores revealed that these factors significantly affected SDSA success, and the subsequent multivariate analysis identified TMT‒B as the only significant factor. There was no significant relationship between SDSA success and sex, lesion laterality, or disease subtype. Physicians who treat patients with neurological impairment should aggressively assess their patients’ driving ability. However, in rural areas in which individuals are car‒dependent, a stereotypic driving ability assessment might be difficult. Efforts to ensure the safe driving ability of patients should be based on medical care but also on social and legal interventions on a region‒wide or nationwide basis.