Objective — Study how GPs assess mental function when a health certificate for elderly drivers has to be issued.

Design — Postal questionnaire survey.

Setting — Nationwide survey.

Subjects — Random sample of 532 Norwegian general practitioners, response rate 54%.

Main outcome measures — Open and closed questions.

Results — Various types of examinations and assessments are carried out in this context. More than 50% always assess mental function. Only 22% use formal mental tests, mostly when in doubt. The assessment of elderly patients for a health certificate for driving is regarded by many as a difficult problem.

Conclusion — There is a lack of uniformity in issuing a health certificate to elderly drivers, a low use of formal cognitive testing, and problems facing GPs in this context. More concrete guidelines and a formal second-line system would facilitate an objective assessment and could also alleviate the burden on the doctor.