Predicting on-road driving performance and safety in cognitively impaired older adults

Abstract

Objectives To evaluate the ability to predict on-road driving in cognitively impaired older drivers. Design Cross-sectional observational study. Setting Laboratory tests and on-road assessment. Participants Drivers with cognitive impairment (Mini-Mental State Examination score < 26, N = 43, mean age 74). Measurements The Roadwise Review, a hazard perception test (HPT), several vision tests, and a standardized 18-km driving assessment. Results The best prediction of passing or failing the on-road test was a combination of the HPT, leg strength, visual acuity, visual search and working memory, and number of medications taken (Nagelkerke coefficient of determination = 0.40). The sensitivity of the model was 71%, and the specificity was 75%. Conclusion Further research is required to determine how these tests may be used or combined with other data (e.g., medical history) to assess fitness to drive of cognitively impaired older drivers.