Individuals with cognitive impairment or dementia are not able to compensate for their functional impairment.  Driving cessation is inevitable when the medical condition is progressive.

When, as a physician, you have a patient who is suspected of having a cognitive impairment, driving issues should be addressed as soon as possible. Your patient and caregivers need time to plan for the loss of driving.

If you suspect your patient has a cognitive impairment, it is recommended you administer a SIMARD MD screening test. This is a valid and reliable screening tool for the identification of cognitively impaired medically at-risk drivers.

There are three possible outcomes for the SIMARD MD test:

• Flagged as fit to drive
• Indeterminate
• Flagged as unfit to drive

Note: Review the section on SIMARD MD for more detail on determining these outcomes

If your patient is ‘flagged as unfit to drive’ or the outcome is ‘indeterminate’, recommend to your patient to stop driving and report this to the OSMV using either the ‘Report of a Condition Affecting Fitness and Ability to Drive’ or your preferred mode of communication with the OSMV.

If your patient is ‘flagged as fit to drive’ plan to repeat the SIMARD MD in one year or if there is a change in your patient’s medical status.