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The results from this study improve our current state of knowledge concerning the CDT by validating the simplified scoring system proposed by Lessig and her colleagues in a more representative sample to mimic conditions a general clinician or researcher will encounter when working among a wide-ranging population and not a dementia/memory clinic. The Jouk CDT scoring system provides further evidence in support of a simple and reliable dementia-screening tool that can be used by clinicians and researchers alike.

We examined the relations between perceived health (e.g., self-perceived health status) and driving self-regulatory practices (e.g., frequency of driving, avoiding challenging driving situations) as mediated by driving attitudes and perceptions (i.e., driving comfort, positive and negative attitudes towards driving) in data collected for 928 drivers aged 70 and older enrolled in the Candrive II study. We observed that specific attitudes towards driving (e.g., driving comfort, negative attitudes towards driving) mediate the relations between health symptoms and self-regulatory driving behaviours at baseline and over time. Only negative attitudes towards driving fully mediated the relationships between changes in perceived health symptoms and changes in driving behavior. Perceived health symptoms apparently influence the likelihood of avoiding challenging driving situations through both initial negative attitudes towards driving as well as changes in negative attitudes over time. Understanding influences on self-regulatory driving behaviours will be of benefit when designing interventions to enhance the safety of older drivers.

Baseline data from a large cohort of 928 older drivers (aged 70 and older) in the Canadian Driving Research Initiative for Vehicular Safety in the Elderly (Candrive II) study permitted the examination of driving specific constructs of perceptions and attitudes based on Social Cognition Theory, the Transtheoretical Model of Behavior Change, and the Theory of Planned Behavior (e.g., driving confidence/comfort, perceived driving ability, and decisional balance) in relation to each other and to various self-reported measures of driving restrictions (i.e., kilometers driven, situations frequently encountered and avoided, degree of driving restriction). Although several of the psychosocial measures were correlated, the magnitudes of the correlations were low enough to suggest that multiple factors were being assessed. In addition, perceptions and attitudes were associated with driving exposure and patterns such that the more positive/comfortable older adults felt about driving and their driving ability, the greater their self-reported driving exposure (e.g., more kilometers driven per week, increased exposure to challenging driving situations/decreased avoidance of challenging situations, fewer restrictions). Conversely, older adults who expressed more negative views about driving, including feeling less comfortable behind the wheel, self-reported driving fewer kilometers per week, avoiding challenging driving situations, and engaging more in active driving restriction compared to more comfortable/confident older drivers. These findings support previous research and extend our understanding of the specific perceptions and attitudes that can contribute to behavior change, particularly for constructs derived from Social Cognitive Theory and the Transtheoretical Model.

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