A diagnosis of mild cognitive impairment (MCI) raises an immediate question about driving. Do you have to stop?

A diagnosis of MCI does not automatically end your licence. It is a different diagnosis from dementia. This article explains what the national guidance says about driving, who decides what happens to your licence, and when an OT driving assessment may help.

What is mild cognitive impairment, and does it mean I cannot drive?

Mild cognitive impairment (MCI) means your thinking skills have changed more than expected for your age. You are still managing daily life. It is a different diagnosis from dementia.

A diagnosis of MCI does not automatically end your driving. The national guidance, Austroads Assessing Fitness to Drive, says MCI does not significantly impair driving, based on limited evidence of increased driving errors.

The same guidance adds a warning. Where more than one thinking skill is affected, such as visuospatial skills, attention and executive function, it may be appropriate to look at your fitness to drive and arrange an assessment.

Which thinking skills matter for driving?

Three are named in the guidance, and each one shows up on the road.

• Visuospatial skills help you judge distance and position. They matter when you pick a gap at a roundabout or position the car in a lane.

• Attention lets you keep track of traffic, signs, pedestrians and your own speed at the same time.

• Executive function covers planning and decision making. It matters when something unexpected happens, like a car pulling out or a road closure.

Our post on how cognitive skills affect driving goes through what the OT is looking for in more detail.

Do I have to tell Transport and Main Roads?

In Queensland you have a legal duty to tell Transport and Main Roads (TMR) about a permanent or long-term medical condition that is likely to affect your ability to drive safely.

Whether MCI meets that test depends on how it affects your thinking skills and your driving. Your doctor or specialist can advise whether yours needs to be reported. Raise it at your next appointment.

Our guide to reporting a medical condition to Queensland Transport explains the process.

When does an OT driving assessment help?

Austroads says the best indication of driving ability comes from a combination of medical assessment and off-road and on-road practical assessments. It says practical assessments suit borderline cases where the effect on driving is unclear.

That describes MCI well. Your test results may be borderline, and no one can tell from paper alone how that looks at 60 km/h.

An assessment has two parts. The off-road part looks at your thinking skills, vision and physical function. The on-road part takes place on real roads in a driving instructor’s car fitted with dual controls. The report goes to your doctor, who sends an updated medical certificate to TMR. Our post on what happens after your OT driving assessment covers who receives what and when.

When you may not need an assessment

An assessment is not always the right next step.

If your doctor and specialist see nothing in your results that affects driving, and you and your family have not noticed any changes, an assessment may not be needed now. Your doctor may instead review you again at a set time and ask you to tell them about any changes.

If you are not sure whether your driving has changed, the signs in how do you know when it is time to get your driving checked are a useful starting point.

What could happen to my licence?

Three outcomes are possible.

• You keep your licence as it is.

• You keep your licence with conditions. TMR lists examples such as daylight-only driving, a distance limit from home, or no freeways.

• You stop driving.

We will not pretend the last one cannot happen. For some people it does. The decision belongs to TMR, which uses your doctor’s medical certificate and any assessment report. The OT does not make it. Our post on licence conditions after an OT driving assessment in Queensland explains what the conditions mean.

What can family do?

If you are a family member reading this, raise your concerns with the person’s doctor and describe what you have seen, such as missed turns on familiar routes. Specific examples help the doctor more than a general worry. Our guide for families on the Gold Coast has more on how to start the conversation.

Ready to book an OT driving assessment on the Gold Coast? Steer Driving is a mobile assessment service covering the Gold Coast and surrounding areas. Whether you already have a referral or you’re just getting started, get in touch and we’ll guide you through the next steps.

This article was written by Elise, an AHPRA-registered Occupational Therapist and driver assessor. Elise is the founder of Steer Driving, a mobile OT driving assessment practice.