Driving, memory loss and dementia

A close up of a hand on a steering wheel

Two leading experts on dementia and memory loss examine the impact that diagnosis can have on people who drive.

One in three people over the age of 75 are still driving and older drivers are generally safer than younger drivers. Many older drivers gradually restrict their driving – familiar routes to the supermarket, relatives and friends are often perceived to be safer, especially if fast roads, bad weather and poor light are avoided.

Surprisingly, accidents are less common at roundabouts, perhaps because older drivers sometimes take routes which avoid them. The manoeuvre that is most likely to result in an older person having an accident is turning right across a stream of oncoming traffic, or at a T junction. Traffic lights help enormously. Over the age of 80, people are more likely to die if they are involved in an accident as they are less resilient in taking the physical and mental shock. This is one reason why insurance premiums sky rocket after the age of 75.

The issue of driving is an area ripe for general comment. Everyone will be familiar with the stories of elderly drivers who press the accelerator instead of the brake and wreak havoc. There are calls for curbs. If public safety was the primary concern, it would be much more effective to restrict driving in young men.

When mild memory difficulties turn into dementia, or if driving seems to be affected by failing faculties, then the DVLA needs to know, and it is the patient who is responsible for telling them. If they won’t, or can’t, then responsibility for notifying the DVLA passes to the doctor. The General Medical Council have clear guidelines.

Being told that you can no longer drive can be a real blow to a person with dementia, their families and carers. As someone put it to one of us recently – ‘The worst thing about being told I had dementia was not the diagnosis. It was being told to stop driving.’

There is a world of difference between making a decision to stop, and being told to stop. Whilst most people know they will have to stop at some point, dementia can make it difficult to recognise when this point has arrived. A crunch point is often when a person with dementia gets lost and returns hours late, or, when they have a bump (thankfully usually minor).  Another common one is when their adult child takes a trip as a passenger and gets a scare. The loss of independence involved can be minor, or may be hugely significant, especially when family cannot help, taxis cannot be afforded, or public transport is not available. An on-road assessment, at one of the Driving Mobility centres can be a good way of getting an objective opinion about whether it is still safe to drive.

Three things are worthy of note. Firstly, whether a person can drive or not is a legal decision not a clinical one. Nevertheless, all practitioners involved in the assessment and care of people with dementia should be assessing the risks, and this should be reviewed at the annual care plan . Many clinicians use the adage that if the son or daughter of a person with dementia is happy for their own kids to go in the car alone with the grandparents, then everything is probably fine.

Secondly, it is a common misbelief that a diagnosis of dementia means the automatic rescinding of a licence. Dr James McKillop, has produced a brilliant guide on the implications of giving up driving and examples of what incidents to look for which may indicate difficulties.

Finally, the decision to stop driving is often one of slow realisation.  Could technology, such as computer touchscreen tests or black box telematics, have a role in informing and nudging the decision?  Like any test, the devil is in the detail. But this is an interesting space to watch – perhaps in the rear view mirror (or more commonly now, the reversing camera!).

Professor Alistair Burns

Alistair Burns is Professor of Old Age Psychiatry at The University of Manchester and an Honorary Consultant Old Age Psychiatrist in the Greater Manchester Mental Health NHS Foundation Trust. He is the National Clinical Director for Dementia and Older People’s Mental Health at NHS England and NHS Improvement.

He graduated in medicine from Glasgow University in 1980, training in psychiatry at the Maudsley Hospital and Institute of Psychiatry in London. He became the Foundation Chair of Old Age Psychiatry in The University of Manchester in 1992, where he has variously been Head of the Division of Psychiatry and a Vice Dean in the Faculty of Medical and Human Sciences, with responsibility for liaison within the NHS. He set up the Memory Clinic in Manchester and helped establish the old age liaison psychiatry service at Wythenshawe Hospital. He is a Past President of the International Psychogeriatric Association.

He was Editor of the International Journal of Geriatric Psychiatry for twenty years, (retiring in 2017) and is on the Editorial Boards of the British Journal of Psychiatry and International Psychogeriatrics. His research and clinical interests are in mental health problems of older people, particularly dementia and Alzheimer’s disease. He has published over 300 papers and 25 books.

He was made an honorary fellow of the Royal College of Psychiatrists in 2016, received the lifetime achievement award from their old age Faculty in 2015 and was awarded the CBE in 2016 for contributions to health and social care, in particular dementia.

Rupert McShane

Rupert McShane is a consultant old age psychiatrist at Oxford Health NHS Foundation Trust. He works with the Academic Health Science Network to help get dementia-related innovations into practice, with the NIHR Clinical Research Network to help get the evidence about what works, and with the Cochrane collaboration to help assess and combine all the evidence that is gathered.


  1. Cheryl Holroyd says:

    Hi , my dad was diagnosed with early onset Alzheimer’s 2 years ago ,he has had a couple of bumps in his car recently not involving other cars.
    He is forgetting more and repeating himself more. His GP has completed the form for the DVLA so he can continue driving , but GP’s don’t sit at the side of their patients when driving to test their capability. My dad won’t give up driving while the GP continues to sign the forms. Is there anyway of getting his ability to drive tested to put our families mind at rest or get help in making the decision to stop him from driving.
    Thanks from a concerned family.

  2. Jayne Hobbs says:

    Our doctor has contacted DVLA regarding my husband and memory problem. We don’t think he was ever assessed for dementia. What happens to the insurance on our two cars as the policies are in his name and I am only a named driver, I have never had my own insurance. We are waiting to here from DVLA regarding this.

    • NHS England says:

      Hi Jayne,

      If you contact your husband’s insurance company, they will be able to confirm what happens with the insurance for both cars.

      Kind regards
      NHS England

  3. Lesley richards says:

    My partner had his driving licence revoked in May 2017 after being told he had memory impairment by a driving assessor at a driving centre in carshalton. Since then my partner has undergone memory tests an MRI scan eye surgery and still the DVLA are refusing to send his licence back. My partner was a HGV driver for over 30 years and was always considered a safe and careful driver with no penalty points or endorsements. Joseph is a very good man and if he believed he was unsafe to drive he would not try to get the licence back. Could you offer any advice? Could you contact Joseph Carey on 01483 837172 tThank you

    • NHS England says:

      Hi Lesley

      We’re not able to give medical advice via this page as we’re not qualified to do so. You could encourage your partner to discuss this with a GP to seek advice, or try and gain further information from the DVLA before speaking to a GP.

      Knd Regards
      NHS England

  4. Alan Robson says:

    As an ex HGV driver and having driven over 1,000,000 (accident free) miles with one speeding ticket(4mph over the 40mph limit,to be told I can lose my licence because I could not remember two questions about something I have never heard of before is hard to understand