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Lazeras C, Bonnet M, Laurens B, Berrut G, Dumas É, Dombret P, Bonin-Guillaume S, Lauwick P, Abramovici F, Soto-Martin M, Goutte V. [Driving: What is the relevance and usability of the Reisberg scale in 2023?]. Geriatr Psychol Neuropsychiatr Vieil 2023; 21:343-346. [PMID: 38093571 DOI: 10.1684/pnv.2023.1118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The publication of the decree on the care of people with neurocognitive disorders brought to the fore the Reisberg's Global Deterioration Scale, a scale that only few clinicians use in memory centers or in geriatric. This scale has a number of limitations, not least of which is that it is obsolete, since it does not take into account disease advances in scientific knowledge with biomarkers. Consequently, the stages evoked no longer correspond to current descriptions. Moreover, it only concerns Alzheimer's disease, whereas in our practice we encounter other neurodegenerative pathologies. Even if we decide to use another global assessment scale, such as the Clinical Dementia Rating or the Functional Assessment Staging, they cannot replace a personalized assessment. Indeed, it is important to stress that this decree does not take into account the relevance of personalized assessments using, for example, neuropsychological tests to estimate driving ability. A personalized assessment accompanied by a real-life driving test would be preferable than a score on a global scale. This article therefore presents the Global Deterioration Scale, highlighting its unsuitability for assessing whether or not to continue driving.
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Affiliation(s)
- Chloé Lazeras
- Centre de mémoire de ressources et de recherche, pôle neurosciences cliniques, CHU de Bordeaux, France
| | - Marie Bonnet
- Centre de mémoire de ressources et de recherche, pôle neurosciences cliniques, CHU de Bordeaux, France
| | - Brice Laurens
- Centre de mémoire de ressources et de recherche, pôle neurosciences cliniques, CHU de Bordeaux, France
| | - Gilles Berrut
- Centre mémoire de ressources et de recherche, pôle hospitalo-universitaire de gérontologie clinique, CHU de Nantes, France
| | - Éric Dumas
- Centre de soins en psychogériatrie « Le Verger des Balans », CM/Accueil de jour/UCC/UHR/Ehpad, Périgueux, France
| | - Philippe Dombret
- Commissions des permis de conduire de la Haute-Garonne, service de médecine légale, CHU de Toulouse, France
| | - Sylvie Bonin-Guillaume
- Présidente du conseil scientifique de la Société française de gériatrie et de gérontologie, Internal Medicine and Geriatric Department, hôpitaux universitaires de Marseille, Assistance publique hôpitaux de Marseille, France
| | - Philippe Lauwick
- Médecin généraliste agréé pour le contrôle de l'aptitude médicale à la conduite, préfecture de Lille ; président Automobile club médical de France-Permicomed, Paris
| | | | - Maria Soto-Martin
- CMRR Gérontopôle du CHU Toulouse, Cerpop, Fédération des Centres mémoire, IHU Health Age
| | - Virginie Goutte
- EA 4468, Université Paris Cité, Maladie d'Alzheimer, Paris, France, Consultation mémoire/Accueil de jour, Ccentre Hospitalier des Quatre Villes, Sèvres, Saint-Cloud, France, Institut d'Enseignement à Distance, Université Paris 8, Saint-Denis, France
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Laurens B, Dumas E, Berrut G, Goutte V, Bonin-Guillaume S, Bonnet M, Lazeras C, Lauwick P, Dombret P, Abramovici F, Martin MS. [Support and guidance in driving for patients with (or suspected of having) Alzheimer's disease or related diseases: position paper]. Geriatr Psychol Neuropsychiatr Vieil 2023; 21:347-362. [PMID: 38093572 DOI: 10.1684/pnv.2023.1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
New ministerial decree restricts driving motorized vehicles for patients with Alzheimer's disease and related disorders. Reisberg stage 3, threshold used to contraindicate driving, appears to correspond to a mild stage of major neurocognitive impairment. A single scale gives an idea of the level of risk but does not provide a holistic assessment. The aim of this consensus is to put forward recommendations from several French learned societies for individualized cognitive assessments to minimize the risks associated with driving and its cessation. Fitness to drive should be raised at the earliest stages of the diagnostic process, and regularly throughout the follow-up. Consult a registered doctor is recommended to all patients wishing to continue driving. All documents must be given to the patient only. An alternative must always be offered to patients who are recommended a modal shift.
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Affiliation(s)
- Brice Laurens
- Centre mémoire de ressources et de recherches, pôle de neurosciences cliniques, CHU de Bordeaux, France
| | - Eric Dumas
- Centre de soins en psychogériatrie « Le Verger des Balans », CM/accueil de jour/UCC/UHR/Ehpad, Périgueux, France
| | - Gilles Berrut
- Centre mémoire de ressources et de recherche, pôle hospitalo-universitaire de gérontologie clinique, CHU de Nantes, France
| | - Virginie Goutte
- Université Paris-Cité, Maladie d'Alzheimer, Paris, France ; Consultation mémoire/accueil de jour, centre hospitalier des Quatre Villes, Sèvres, France ; Institut d'enseignement à distance, Université Paris-8, Saint-Denis, France
| | - Sylvie Bonin-Guillaume
- Présidente du Conseil scientifique de la Société française de gériatrie et de gérontologie, Internal medicine and geriatric department, hôpitaux universitaires de Marseille, Assistance publique hôpitaux de Marseille, France
| | - Marie Bonnet
- Centre mémoire de ressources et de recherches, pôle de neurosciences cliniques, CHU de Bordeaux, France
| | - Chloé Lazeras
- Centre mémoire de ressources et de recherches, pôle de neurosciences cliniques, CHU de Bordeaux, France
| | - Philippe Lauwick
- Médecin généraliste agréé pour le contrôle de l'aptitude médicale à la conduite, préfecture de Lille, président Automobile club médical de France-Permicomed, Paris
| | - Philippe Dombret
- Commissions des permis de conduire de la Haute-Garonne, service de médecine légale, CHU de Toulouse, France
| | | | - Maria Soto Martin
- CMRR Toulouse, Gérontopôle de Toulouse, CHU Toulouse, UMR Inserm 1295 Cerpop, IHU HealthAge
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