Doctors could ask patients to sign advance driving directives in an attempt to reduce the emotionally vexed issue of fitness-to-drive assessments, researchers suggest.

The idea is outlined in a small study, published in the Australasian Journal on Ageing, in which patients with mild cognitive impairment or dementia discussed how they would like to be told when they were no longer safe to drive.

“Be straight up. Not blunt, but nicely,” was the response of one participant.

Another man told the SA researchers that he had received a letter ordering him to undergo a practical driving test, without any prior warning or discussion. He said he felt it had been done “behind my back”.