Validity of the Mini‐Mental State Examination and the Montreal Cognitive Assessment in the Prediction of Driving Test Outcome

Hollis, Ann M.; Duncanson, Haley; Kapust, Lissa Robins; Xi, Patricia M.; O’Connor, Margaret

doi:10.1111/jgs.13384

Cited by 46 publications

(28 citation statements)

References 17 publications

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“…We expect that the attention subtest will be related to driving competence because capacity for focused attention affects driving . Consistent with our prior work and factor analytic studies, we anticipate that MMSE subtests will be differentially associated with driving in CI vs NCI groups . Findings from the current study will provide important information regarding the driving implications of specific MMSE subtests.…”

supporting

confidence: 74%

“…Some studies demonstrated a significant association between the MMSE and driving whereas others have not . In a prior study, our group highlighted selection biases as potential confounds . MMSE scores of older drivers with no cognitive impairment (NCI) had little variance; hence the MMSE was not useful to identify pass/fail outcome.…”

mentioning

confidence: 97%

“…[6][7][8][9] In a prior study, our group highlighted selection biases as potential confounds. 10 MMSE scores of older drivers with no cognitive impairment (NCI) had little variance; hence the MMSE was not useful to identify pass/fail outcome. In contrast, we found that people with a diagnosis of CI showed a robust relationship between MMSE performance and driving fitness.…”

mentioning

confidence: 99%

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Use of the MMSE in the Prediction of Driving Fitness: Relevance of Specific Subtests

O’Connor

Duncanson

Hollis

2019

J American Geriatrics Society

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OBJECTIVES To examine the association between performance on subtests of the Mini‐Mental State Examination (MMSE) and driving competence in people with cognitive impairment (CI) as well as those with no cognitive impairment (NCI). DESIGN Retrospective observational study. SETTING Participants referred for a DriveWise evaluation at Beth Israel Deaconess Medical Center in Boston, Massachusetts, were included in the study. PARTICIPANTS A total of 419 participants referred for a DriveWise evaluation was studied. The average age of the sample was 77.69 years. In this study, people with an MMSE score lower than 25 were included in the CI group; 41% of participants had CI. MEASUREMENTS All participants underwent mental status screening with the MMSE, and all underwent a 45‐minute road test modeled after the Washington University Road Test adapted for use in Boston streets. RESULTS In both groups, poor road test performance was associated with low scores on the MMSE. In drivers with CI, MMSE total score and performance on the attention subtest were significantly lower for those who failed the road test. In drivers with NCI, the MMSE total score and orientation subtests were significantly lower for those who failed the road test. CONCLUSIONS Clinicians working with older people should know that the MMSE is an effective tool to screen for driving safety, but MMSE subtests are differentially sensitive to driving safety in people with and without CI. Poor performance on specific MMSE subtests may prompt further evaluation of driving competence with a road test. J Am Geriatr Soc 67:790–793, 2019.

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confidence: 74%

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confidence: 97%

mentioning

confidence: 99%

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Use of the MMSE in the Prediction of Driving Fitness: Relevance of Specific Subtests

O’Connor

Duncanson

Hollis

2019

J American Geriatrics Society

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“…Screening tools such as the Mini-Mental State Examination (MMSE) and Montreal Cognitive Examination (MoCA)23 do not correlate well with driving ability and should not be used to predict driving risk 22 24. While low scores do not necessarily indicate high risk, and high scores do not reliably predict safe driving, they may be useful as part of a more detailed clinical assessment process.…”

Section: Introductionmentioning

confidence: 99%

“…While low scores do not necessarily indicate high risk, and high scores do not reliably predict safe driving, they may be useful as part of a more detailed clinical assessment process. It has been suggested that a score of ≤24 on the MMSE should lead clinicians to consider recommending a driving evaluation,25 and a score of ≤18 on the MoCA should alert clinicians to increased likelihood of significantly increased driving risk 24…”

Section: Introductionmentioning

confidence: 99%

Driving and dementia: a clinical update for mental health professionals: Table 1

Allan

Behrman

Baruch

et al. 2016

Evid Based Mental Health

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Most people with mild dementia can continue to drive, but dementia is progressive and many patients and clinicians will be faced with questions about driving safety in the course of their illness. Determining when this happens is a complex decision, with risks of personal and public safety needing to be weighed against individual patient benefits of driving in terms of autonomy, independence and well-being. Decisions need to make reference to cognitive abilities, as well as other factors including physical comorbidity, vision, mobility, insight and history of driving errors and accidents. Deciding to stop driving, or being required to stop driving is often difficult for patients to accept and can be a particularly problematic consequence of a dementia diagnosis. Legal frameworks help in decision-making but may not provide sufficient detail to advise individual patients. We review the current guidelines and evidence relating to driving and dementia to help clinicians answer questions about driving safety and to consider the full range of assessment tools available. INTRODUCTIONWe are becoming ever more dependent on driving; in 2014 81% of people aged 60-69 years and 62% of those over 70 years old in the UK held a full driving licence.

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Capacity to Manage Critical Domains of Living: Driving, Voting, and Sexual Expression

Marouf

2019

Psychiatric Ethics in Late-Life Patients

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Validity of the Mini‐Mental State Examination and the Montreal Cognitive Assessment in the Prediction of Driving Test Outcome

Cited by 46 publications

References 17 publications

Use of the MMSE in the Prediction of Driving Fitness: Relevance of Specific Subtests

Use of the MMSE in the Prediction of Driving Fitness: Relevance of Specific Subtests

Driving and dementia: a clinical update for mental health professionals: Table 1

Capacity to Manage Critical Domains of Living: Driving, Voting, and Sexual Expression

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