OTOtherCanadian journal of occupational therapy. Revue canadienne d'ergotherapie2023

Clinical Tests Predicting On-Road Performance in Older Drivers with Cognitive Impairment.

Sarah Krasniuk, Alexander M Crizzle, Ryan Toxopeus and 2 others

PMID 35950229

WHAT IT FOUND

Clinical tests predicted on-road pass/fail only moderately in older drivers with cognitive impairment.

No test was clearly better, and the Trails B misclassified many drivers. Neither should decide fitness alone.

Key findings

01The Trails B, UFOV subtest 2, UFOV subtest 3, and UFOV Risk Index showed only moderate ability to predict on-road pass/fail, and the Trails B was not clearly better than the UFOV measures.

02A Trails B cut-point of 3.58 minutes misclassified 31.7% of drivers who passed and 32.3% of drivers who failed.

03A UFOV subtest 3 cut-point of 467 ms correctly flagged 78.9% of drivers who failed and 73.5% of drivers who passed.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The data did not confirm the type or severity of cognitive impairment, only MoCA scores. All drivers had been referred by physicians for a driving evaluation, so the results may not apply to people seen in primary care. Medication information was not collected, so medication effects on test scores or driving could not be examined. Twenty-eight drivers did not complete all clinical tests, so the cut-point analyses used 72 drivers rather than 100. Pass/fail decisions could have differed between the two assessment centers, although the therapists' on-road scoring was based on completing at least half of maneuvers correctly. The Trails B and UFOV may not capture all cognitive demands of driving.

Declared interests

The work was supported by the University of Waterloo CIHR Research Incentive Fund.

The easy way to misread this

Do not conclude that the Trails B or UFOV can decide fitness to drive on their own. The Trails B misclassified many drivers, and even the UFOV subtest 3 cut-point wrongly cleared some drivers who failed and wrongly flagged some drivers who passed.

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