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To summarise the available literature on driving with Alzheimer's disease (AD) and to investigate the relationship between driving and cognitive functioning.Literature review.A systematic search of the electronic databases PubMed/MEDLINE was conducted to select the relevant literature on the driving competence of patients with Alzheimer's disease.A total of 31 studies were selected that investigated driving competence in AD using either an on-road driving assessment or a driving simulator. The driving competence of patients with AD was less accurate compared with controls. The most commonly made errors included errors in staying in lane, lane changing, slower reaction times, and more fluctuations in speed. Cognitive functioning was more predictive of driving competence than a diagnosis of AD alone.Based on the available literature it is difficult to determine when patients with AD should be restricted in their driving. In addition, there is currently no consensus on which neuropsychological tests are useful in clinical practice to predict driving competence. Specific practical guidelines that can be implemented in daily practice are still lacking.