The article discusses the relationship between mandatory reporting of dementia to vehicle licensing agencies and the potential underdiagnosis of dementia by physicians. Here are the key points:

1. A study by Jun et al. conducted a cross-sectional ecological analysis of four states with mandatory fitness-to-drive reporting of dementia.
2. The results suggest that mandatory reporting is associated with an increase in physicians underdiagnosing dementia:
   • 12.4% in states with mandatory reporting
   • 7.8% in states with driver self-reporting
   • 7.7% in states with no mandates
3. The implication is that mandatory reporting may be aversive to patients and clinicians, leading to widespread underdiagnosis.
4. The article cautions against drawing causal conclusions from this correlation, as there could be other factors influencing the results.
5. The tension between patient privacy and community safety in relation to dementia and driving is highlighted as a complex issue.
6. The importance of counseling patients about road safety is emphasized, regardless of government mandates.
7. The article notes that while mandatory reporting may have unintended consequences, it’s essential for clinicians to address driving safety with dementia patients.
8. The authors suggest that tactful counseling, focusing on practical alternatives and treating comorbidities, is crucial when discussing driving limitations with dementia patients.

The article ultimately emphasizes the need for a balanced approach to addressing dementia and driving safety, considering both patient care and public safety concerns.

Redelmeier DA, Bhatt V. Dementia, Driving, and the Duty to Warn. JAMA Netw Open. 2024;7(4):e248856. doi:10.1001/jamanetworkopen.2024.8856