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Dementia

Stage

Typical Cognitive

Scores*

Cognitive and Functional levels Driving Recommendation No

Dementia

MMSE:> 27/30 ACE-III:> 90/100 MOCA :> 26/30 RUDAS:>26/30

No cognitive impairment:

Normal memory and cognition

Independent function

Competent in home, work and hobbies

May continue to drive

Check for other Medical Conditions

Mild

Cognitive

Impairment

MMSE: 24 - 27/30

ACE-III: 80-90/100

MOCA:18 - 26/30

RUDAS: 23-26/30

A mild but noticeable decline in cognition:

Mild forgetfulness

Mild disorientation

Mild impairment in problem solving

Generally independent in most activities

May struggle with complex tasks

Most people Safe to Drive

Consider OT driving assessment. Restricting or stopping driving if:

Family concerns

Recent accidents or near misses

Functional impairment in some complex tasks

Behavioural disinhibition - ͞risk-taking"

(Notify NZTA) Mild

Dementia

MMSE:18-23/30 ACE-III: 65-76/100 MOCA : 11-17/30 RUDAS: 17-22/30

Definite cognitive decline and impairment

Moderate memory loss and disorientation

Impaired problem solving

Mild impairment in household tasks / personal cares

Requires prompts or supervision with some tasks

Complex tasks and roles no longer possible

Social interactions often well preserved

Driving safety is uncertain

Some people safe, others unsafe to drive

Safety not predicted by Cognitive testing / Dementia stage

Person needs further investigation / review

OT Driving Assessment ** Preferred and Recommended

Further Collateral History

Clarification of Function level in other areas

Driving Questionnaires

Further Cognitive testing

Alternative on -road driving assessment

Second Opinion

Clinical Decision needs to be made!

Continue Driving - Review Date

Restricted Driving - Review Date, or

Notify NZTA

Moderate

Dementia

MMSE:10 - 18/30

ACE-III: 35 -64 /100

MOCA : 6 - 10 /30

RUDAS: 10 - 16/30

Significant impairment of cognition/function

Marked memory loss

Disorientation to time and place

Decreasing ability to make judgements

Decreasing ability to engage socially

Decreasing ability to function independently

Needs assistance with personal cares

Requires supervision when leaving home

May get lost when away from home

Limited capacity to complete tasks in home

No longer able to participate in usual activities

Must Stop Driving!

Notify NZTA

Severe

Dementia

MMSE:<10/30 ACE-III: <35 /100 MOCA : <6 /30 (or not testable) RUDAS: <10/30

Profound impairment of cognition / function

Severe memory impairment / disorientation

Spoken language limited or lost

Incontinence

No capacity for making judgements

High dependency on others for personal cares

Unable to contribute to household chores

Often unable to recognise family members

Increasing loss of psychomotor skills

Frequent behaviour or psychiatric complications

Must Stop Driving!

Notify NZTA

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