Driving Errors Predicting Pass/Fail On-Road Assessment Outcomes Among Cognitively Impaired Older Drivers.
Sarah Krasniuk, Diane Mychael, Alexander M Crizzle
PMID 35337241WHAT IT FOUND
For older drivers with cognitive impairment, three specific on-road errors predict failing a driving assessment: adjusting poorly to traffic, drifting from the lane, and regulating speed badly.
These errors occurred in 98.8%, 91.3%, and 98.8% of drivers respectively, distinguishing those who failed from those who passed.
Key findings
01Drivers who failed the on-road assessment made significantly more errors in adjusting to stimuli, lane maintenance, and speed regulation than those who passed.
02Adjustment to stimuli, lane maintenance, and speed regulation errors collectively predicted pass/fail outcomes with 87.5% accuracy.
03Poorer performance on the Trails B and UFOV tests correlated with these specific driving errors, suggesting these clinical tests can help identify drivers at risk for these maneuvers.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was retrospective and based on data from a single driving assessment center in Ontario. Participants were referred by physicians for concerns about cognitive capacity, meaning the sample may represent a higher-risk group than the general population of older drivers with cognitive impairment. The study did not control for age in the regression analysis, so it is unclear how much of the driving error was due to cognitive impairment versus general aging. Specific diagnoses (e.g., Alzheimer's vs. other dementias) were not collected, only the presence of cognitive impairment. The context of the errors (e.g., residential vs. highway) was not analyzed, so it is unclear if certain environments drove specific failures.
Declared interests
The authors declared no conflicts of interest. The study was funded by the University of Waterloo Canadian Institutes of Health Research (CIHR) Research Incentive fund.
The easy way to misread this
Do not assume that a high score on a general cognitive screen like the MoCA guarantees safe driving. This study shows that specific functional errors (lane maintenance, speed regulation) are the best predictors of failure, and these were linked to attention deficits found on more specific tests like the UFOV and Trails B.