Predictors of driving safety in early Alzheimer disease

Abstract

Drivers with Alzheimer disease (AD) exhibit a range of performance on tests of cognition, vision, and motor skills. Since these tests provide additional predictive value of driving performance beyond diagnosis alone, clinicians may use these tests to help predict whether a patient with AD can safely operate a motor vehicle.

Comparing Caregiver and Clinician Predictions of Fitness to Drive in People With Alzheimer’s Disease

“…Standardized road tests are considered the gold standard for monitoring driving fitness in older adults (Carr & Ott, 2010). Standardized road test performance relates well to available office-based cognitive assessments and to history of motor vehicle crashes (Barrash et al, 2010;Brown, Stern, et al, 2005;Dawson, Anderson, Uc, Dastrup, & Rizzo, 2009;Fitten et al, 1995;Grace et al, 2005). The standardized road test is also a reasonable proxy for estimating older people's driving ability in their routine driving environments Ott et al, 2012).…”

Road safety in drivers with Parkinson disease

“…The experimental drive was conducted aboard ARGOS, a mid-sized instrumented vehicle with an automatic transmission and hidden instrumentation and sensors. 5,11,12,[16][17][18] The road test was usually administered within a few weeks of cognitive and visual testing, sometimes on the same day. The experimental drive lasted approximately 45 minutes, and the subjects drove across residential city streets, suburban commercial strips, rural 2-lane highways, and a 4-lane 65 mph speed limit freeway.…”

“…18,19 As shown in our previous work, 11 the driving instructor reviewed tapes with a multiplex view using 4 channels of video (including forward roadway the driver should see and position of the car relative to the lane) with superimposed digital driving data, which included speed, enabling comparison of the actual speed to the speed limit at any moment of the drive and detection of lane deviation errors. This approach allowed a standard review of all drives, including multiple views of the driver, car, road, and traffic.…”

“…The reviewer assessed the number and type of safety errors committed by the subjects, using a list of 76 error types (e.g., "unsafe passing") organized into 15 categories (e.g., "stop signs," "lane observance"). 18,19 This list was based on the Iowa Department of Transportation's Drive Test Scoring Standards ( September 7, 2005, version). The subjects were told to drive as they would in their usual life and there was no overall pass/fail judgment.…”

“…The subjects were told to drive as they would in their usual life and there was no overall pass/fail judgment. 18 The primary outcome measure was the total number of safety errors. All other comparisons (error categories, "serious" errors) were of exploratory nature.…”