DVLA guidance recognises that it is difficult to assess driving ability in people with cognitive impairment, as each case can be different, and dependent on other factors.

 

Medical professionals have the largest role to play in this decision but do not normally see the driver behind the wheel.

 

To help this process, a judgement can be made by a professional driving assessor who has an extensive understanding of what to look for, who can then report back to the doctor for a final decision on fitness to drive.

 

In reality, it is often a family member or carer that takes on this responsibility as 

it is very unlikely that the driver can make this decision themself.

Considerations include:
1. Poor short-term memory and disorientation. Getting confused about a route or even becoming lost may not, in itself, be a big risk factor. However, this may cause anxiety and stress which can affect decision making and judgement, significantly increasing risk of a collision. It may also lead to driving on a complex road layout which is normally avoided for safety reasons, by mistake.
2. Visuospatial awareness is often compromised when someone develops a cognitive impairment. This may mean the driver cannot judge a safe road position properly and may get too close to obstacles. Safe use of a car park may also be a problem.
3. Multi-tasking skills may be diminished which will not always show up on familiar roads, but will when the situation becomes more complex. Good multi-tasking skills are essential for safe driving, so that the actual driving task can be carried out whilst also operating essential peripheral controls, taking note of road signs and being aware of the actions of other road users.
4. The ability to stay focused on road hazards both in front and behind is also important. Cognitive impairment can potentially affect concentration and focus.