B-05_Dow - Driver Fitness Screening - Is It Safe for My Patient to Drive?

Sep 19, 2026

Guidance for family physicians on evaluating whether it is safe for patients to drive, emphasizing that driver fitness depends on functional impairments rather than age alone. Outlines workshop objectives to recognize red flags, apply basic screening tests, and refer patients to appropriate driver-fitness evaluation resources. Provides context on the projected growth of older drivers and explains how driving requires judgment, self-awareness, divided attention, rapid visual processing, and autonomy. Notes limitations of office-based determination and summarizes evidence about cognitive test predictability.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages26

Reading Time1 h 6 min

AccessFree to download

Objectives

Context and Driving Complexity

Medical Fitness to Drive

Red Flags for Compromised Fitness

Cognitive Status and Test Predictors

Is it safe for my patient to drive? Jamie Dow md Direction de la recherche et dudéveloppement en sécurité routière 26 November 2018 69th Annual Refresher Course for Family Physicians Faculty of Medicine, McGill University Conflicts • No relationship with any commercial company • Full-time employee of the SAAQ. Objectives Following this workshop a physician will be able to: • Recognise signs of possible unfitness to drive in their patients • Apply basic screening tests for fitness to drive • Refer patients with a possible compromise of their fitness to drive to the appropriate driver-fitness evaluation resource Context • Predicted increase in older drivers over the next 15 years • 2008 8% • 2018 18% • 2025 25%(30%?) As people age they are more likely to have at least one of the medical conditions known to influence driver fitness. 62% of drivers aged 70-79 have at least one such condition Driving: a complex task • For most people, the most complex task undertaken during their regular daily activities • Requires: • Judgement • Self-awareness • Intact divided attention • Rapid processing of (mostly visual) data and decision-making • Autonomy at the wheel How complex? BUT: • Age is not a criteria in determining driver fitness • Medical unfitness to drive can occur at any age • Usually diagnoses alone do not determine driver fitness, it is the functional impairments that result from the medical conditions that are the major factor. • Often a road test is necessary Medical fitness to drive Practically speaking, it is difficult to determine fitness to drive in an office setting unless the unfitness, or fitness, is blatently evident – e.g. severe dementia. SAAQ does not ask physicians to determine fitness to drive. Physicians are asked to provide accurate medical information and to communicate any unsettling findings that may indicate potentially compromised driver fitness Red flags • Any impairment, physical or cognitive, that affects their quality of life or their daily activities • Voluntary changes to their usual driving activities • Only drives in their local area • Only drives in daylight and/or good weather • Avoids rush hour, busy periods or autoroutes • Visual problems (cataracts, low acuity, visual field defects) A change in cognitive status? • There are no cognitive tests or battery of tests that may be used as the sole determinant of driver fitness. • No correlation between results on the Clock, MoCA, MMSE (Folstein) and on-road performance • The only tests that are predictive of driver performance are the Trail Making Test Band the Useful Field of View (UFOV) . • The Maze Test, Trail Making Test A reversed and the Colour TMT have potential but have not been validated in this context.

FAQs

Is age a criterion for determining a patient’s fitness to drive?

No. Age is not used as a criterion; medical unfitness to drive can occur at any age. Functional impairments resulting from medical conditions are the major factor.

What should physicians do during screening for driver fitness?

Physicians should recognize signs of possible unfitness, apply basic screening tests for fitness to drive, and refer patients with potentially compromised fitness to the appropriate driver-fitness evaluation resource.

Can office-based testing reliably determine fitness to drive?

Not reliably. It is difficult to determine fitness to drive in an office setting unless unfitness is blatantly evident, such as severe dementia.

Sep 19, 2026

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