Licensed physicians in Denmark are obliged to assess fitness to drive a car in patients suspected of impaired cognitive functions. Existing regulations stipulate, that fitness to drive can be assessed through screening of cognitive function using a test of orientation, clock-drawing and ability to recall three words. Evidence in support of this screening procedure seems sparse. Based on relevant published studies the authors of this review find, that no existing simple "off-road" test reliably assesses fitness to drive. In some settings combined neuropsychological- and simulator drive tests seem promising.