中高齡認知障礙汽車駕駛者的適性駕駛評估

Taiwan is a society with a growing number of older drivers. This demographic is susceptible to age-related medical conditions, such as mild cognitive impairment (MCI) or dementia, which may affect their driving capacity and lead to higher crash risk. Screening and regulating these at-risk drivers have been heavily debated in Taiwanese society, but no clear consensus has been reached. To fill this gap based on scientific evidence and sophisticated experiences, this review article will summarize current literature about screening and evaluation concerns among drivers with cognitive impairments and introduce driver rehabilitation practices from several Western countries to a Taiwanese audience. There are three parts in this article. The first part clarifies the relationship between age, cognitive function and crash risks among older drivers with cognitive impairments. Current evidence suggests that neither age nor the diagnosis of MCI should be the single criterion to revoke one's driver's licence. The second part addresses the importance of driving in older adults and the means to prolong safe driving performance in persons who are still capable of driving. Through proper interventions and acts, driving can enhance older adults' outdoor mobility and social participation without compromising traffic safety. The third part introduces the screening and evaluation procedure of at-risk drivers in the United States, Canada, and Australia. This section also presents several evidence-based in-office assessment tools and on-road driving evaluations that are commonly administered by trained occupational therapists. This article provides an overview of research and clinical practices related to at-risk drivers in several countries. In Taiwan, involvement in the regulation of at-risk drivers should also be one of the responsibilities of occupational therapists, because these professionals have the expertise to analyze drivers' occupational profile and occupational performance. It is expected that more Taiwanese occupational therapists will engage in advanced, specified training in driver rehabilitation, and that more localized studies will focus on Taiwanese drivers' habits and environment.