Predicting On‐Road Driving Performance and Safety in Cognitively Impaired Older Adults

Ross, Rachel W. Jones; Scialfa, Charles T.; Cordazzo, Sheila Tatiana Duarte

doi:10.1111/jgs.13712

Cited by 14 publications

(5 citation statements)

References 24 publications

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“…As with previous research [20], there is an obvious interest in a specific "cut off" score for the various clinical groups to help guide clinicians in their recommendations around driving. The results of the specificity and sensitivity analysis in this research suggests that a 120 second time cut off may be a clinically relevant marker, as both the NPV and PPV score around 70% (NPV is 72% and PPV 68%), which is a clinically accepted level for these scores [29,30]. This is similar to research presented by Ma'u and Cheung [31] within a dementia diagnosis population.…”

Section: Discussionsupporting

confidence: 85%

A retrospective review of the potential relationship between the TMT B and on-road driving performance within a community rehabilitation setting

Hinckley,

Patterson,

Matigian

2024

Edorium J Disabil Rehabil

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Aims: Occupational therapy (OT) driving assessments provide the gold standard approach to determine fitness to drive post-injury, medical event, and aging. However, these assessments are time intensive, costly and are associated with lengthy waitlists. As such, there is interest to investigate innovative approaches, including the use of the Trails Making Test B (TMT B), to assist clinicians with their decisions around returning to driving. The aim of this research was to explore potential correlations between TMT B scores and driving assessment outcomes. Methods: Trails Making Test B data were collected between 2010 and 2019 within a publicly funded community-based driving service in Brisbane, which serviced a wide range of client diagnostic groups and age ranges (17–94 years). A retrospective analysis was completed to compare with the on-road OT driving assessment outcome. Results: Results indicate a statistically significant relationship between TMT B score with on-road driving performance, with a higher confidence of predictability in the younger age groups (defined as 63 years or younger). Age is also related to on-road performance, with older clients more likely to fail. A 120 second time cut off may be a clinically relevant marker in predicting on-road performance, particularly for the younger clients. Conclusion: The TMT B is useful tool to assist in the decision making around returning to driving to aid in the timing and need of on-road driving assessment and to potentially assist with decision making in situations where these assessments are not practically available. Clinicians can consider the risk versus the benefits of the test as a predictive tool given their specific contextual environment and access to on-road driving assessments.

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Section: Discussionsupporting

confidence: 85%

A retrospective review of the potential relationship between the TMT B and on-road driving performance within a community rehabilitation setting

Hinckley,

Patterson,

Matigian

2024

Edorium J Disabil Rehabil

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“…A failure of any one of the tests that make up Safe Driving BASICS would be considered inadequate by the Iowa DOT. The individual tests that make up Safe Driving BASICS identify older drivers whose scores place them in a group at statistically higher risk of a crash [2,5,[11][12][13]. The on-road driving test is the primary determinant of a person's ability to continue driving.…”

Section: Variablesmentioning

confidence: 99%

“…Currently, there is little guidance on exactly at what point in the disease progression that the driver's license should be restricted or denied. Cognitive impairment has been linked to poor performance on screening tests used to identify decreased driving ability and on driving examinations [2][3][4][5][6][7]. Despite this decreased performance, studies of medical records linked to licensing records fail to attribute a higher crash risk to drivers diagnosed with dementia [6,8,9].…”

Section: Introductionmentioning

confidence: 99%

The Medical Referral Process and Motor-Vehicle Crash Risk for Drivers with Dementia

et al. 2020

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Cognitive and physical impairment can occur with dementia and reduce driving ability. In the United States, individual states have procedures to refer and evaluate drivers who may no longer be fit to drive. The license review process is not well understood for drivers with dementia. This study uses comprehensive data from the Iowa Department of Transportation to compare the referral process for drivers with and without dementia from January 2014 through November 2019. The likelihood of failing an evaluation test was compared between drivers with and without dementia using logistic regression. The risk of motor-vehicle crash after referral for review of driving ability was compared using a Cox proportional hazard model. Analysis controlled for the age and sex of the referred driver. Drivers with dementia performed worse on all tests evaluated except the visual screening test. After the referral process, the risk of crash was similar between those with and without dementia. Drivers with dementia were denied their license more frequently than referred drivers without dementia. However, drivers with dementia who successfully kept their license as a result of the license review process were not at an increased risk of crash compared to other referred drivers.

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“…In these tests, drivers are shown video clips on a computer screen and asked to respond (with a button, computer mouse, or touch screen) as soon as they anticipate that a dangerous situation is developing. Drivers’ average response time in these tests has been found to correlate with on-road driving performance (Grayson, Maycock, Groeger, Hammond, & Field, 2003; Ross, Scialfa, & Cordazzo, 2015; Wood, Horswill, Lacherez, & Anstey, 2013). One advantage of this sort of test is that it separates hazard-perception ability from other components of driving behavior with which hazard perception is naturally confounded in real driving, such as speed choice (e.g., choosing faster speeds changes both the nature of the hazards drivers encounter and the time available to detect hazards).…”

Section: Why Is Hazard-perception Ability Considered Important For Romentioning

confidence: 99%

Hazard Perception in Driving

Horswill

2016

Curr Dir Psychol Sci

107

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Hazard perception in driving refers to a driver’s ability to anticipate potentially dangerous situations on the road ahead and has been the subject of research for over 50 years. It is typically measured using computer-based hazard-perception tests and has been associated with both retrospective and prospective crash risk, as well as key crash-risk factors such as distraction, fatigue, alcohol consumption, speed choice, and age-related declines. It can also differentiate high- and lower-risk driver groups. The problem is that it is also a skill that appears to take decades of driving experience to acquire. This raises the question of whether it is possible and practical to accelerate this learning process via assessment and training in order to improve traffic safety. We have evidence that, in contrast to most driver education and assessment interventions, hazard-perception testing and training appear to have the capability to reduce crash risk. For example, the inclusion of a hazard-perception test in the UK driver licensing process has been estimated to reduce drivers’ non-low-speed public-road crash rates by 11.3% in the year following their test.

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Predicting On‐Road Driving Performance and Safety in Cognitively Impaired Older Adults

Cited by 14 publications

References 24 publications

A retrospective review of the potential relationship between the TMT B and on-road driving performance within a community rehabilitation setting

A retrospective review of the potential relationship between the TMT B and on-road driving performance within a community rehabilitation setting

The Medical Referral Process and Motor-Vehicle Crash Risk for Drivers with Dementia

Hazard Perception in Driving

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