A CDT score less than 5 out of 7 points was associated with significantly more driving errors and hazardous driving, indicating the need for a formal driving evaluation. Furthermore, a poor clock drawing test (CDT) performance has been correlated with a decline in driving aptitude evaluated by a driving simulation in a prospective cohort study. Cognitive evaluation tests such as the Montreal Cognitive Assessment (MoCA) are considered to be useful screening tools to detect declining driving performance, but their predictive properties have shown low sensitivity (84.5%) and specificity (50%) with a cutoff score ≤25.
#ANSWERS TO MOCA TEST DRIVERS#
īased on the current literature, cognitive tests alone have not shown a high predictive value in predicting unfit drivers and driving cessation. The literature also fails to clearly distinguish the old from the new version of the test, making it difficult to clearly assess its ability to predict on-road events. It is, however, not clear how the instrument has managed to distinguish cognitive decline from visual reduction in contrast sensitivity or visual acuity, which also affects test and driving performance. Normative values, based on measures taken from drivers referred to specialized centers for testing, have been used to define benchmarks for clinical practice. The UFOV, a computer-based test that evaluates visual processing speed and attention, has been developed and investigated as a tool to detect poor driving performance and has been correlated with increased risks of on-road accidents. Furthermore, TMT can be a useful tool in evaluating driving performance, as it can estimate various functions, such as visual scanning, executive function and graphomotor speed.
In older drivers, the TMT has a 63,6% sensitivity, 64,9% specificity, low positive predictive value (9,5%) and high negative predictive value (96,9%) for poor driving performance in a translational study. Among the promising neuropsychological tests, the Trail Making Test (TMT-A and TMT-B) and the useful field of view (UFOV) were estimated to be predictors of unsafe driving in a meta-analysis.
Ĭoncerning the individual screening strategies, many clinical tests to evaluate the driving aptitude of patients, including cognitive, mental, motor and vision tests, have been proposed. Supporting and stimulating out-of-home mobility in the elder population, detecting and preventing a functional decline and possible future driving cessation, depends on individual screening strategies, as well as on transport policy and social policy measures. As many adverse health problems have been related to driving cessation in later life, predicting and evaluating accurately the decline of driving capacity of older drivers is of critical importance. Il is well established the association between driving cessation and functional dependency, depressive disorders, social dysfunction and mortality, with a considerable individual and societal impact. Research has shown that maintaining out-of-home mobility is of great importance for people moving to old age from late midlife. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist.įitness to drive in the geriatric population and the potential effects of cognitive and physical decline remain a difficult challenge for primary care physicians. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All data and statistical analysis files are available in Zenodo ( ).įunding: BF and PV were supported by a grant from the Department of Medicine and Community Health of the University Hospital of Lausanne, Switzerland. Received: Accepted: AugPublished: August 20, 2021Ĭopyright: © 2021 Kokkinakis et al.
Akinwuntan, University of Kansas Medical Center, UNITED STATES Citation: Kokkinakis I, Vaucher P, Cardoso I, Favrat B (2021) Assessment of cognitive screening tests as predictors of driving cessation: A prospective cohort study of a median 4-year follow-up.
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