Older Adults with Cognitive Challenges Require Tests to Ensure They Can Drive Safely
Monday, November 23, 2015
Older adults have the highest rate of collisions per distance driven, even when they limit their driving—and older adults who have cognitive impairments such as Alzheimer’s disease are 2.5 to 4.7 times more likely to be involved in collisions than older adults who aren’t living with such conditions.
In a new study published in the Journal of the American Geriatrics Society, researchers from the University of Calgary in Alberta, Canada, studied which driving tests can best predict on-road performance in older adults with cognitive impairments.
The research team recruited 43 older adults who were diagnosed with mild cognitive impairment or early-stage Alzheimer’s disease. After taking a series of visual tests, the participants took the Mini Mental State Examination (MMSE), which measures cognitive impairment, as well as the Roadwise Review test. Roadwise Review, which you can find and take online, measures eight capabilities needed for safe driving, including working memory, the ability to see when the quality of light is low or high, leg strength and general mobility, and being able to visualize missing information (an important skill that helps drivers react to road conditions or unforeseen events). Finally, the participants took a brief Hazard Perception Test (HPT), which includes a series of 26 silent driving scenes, many involving a traffic condition that requires evasive action.
In a second session for the study, participants took an on-road driving evaluation. The participants had to drive about 11 miles through mixed residential and commercial areas. The trips lasted between 35 and 45 minutes. Trained driving instructors evaluated each driver’s performance and were on-hand to ensure participant safety.
The researchers discovered that the best prediction of passing or failing the on-road test was a combination of the HPT, leg strength, visual acuity, and working memory. As a result, they suggested that older drivers who have cognitive impairment should be assessed with a battery of tests that measure different abilities. What’s more, older drivers should consider taking periodic driving lessons with an expert, and should practice their driving skills regularly, suggested study author Dr. C.T. Scialfa, Emeritus Professor of Psychology, University of Calgary in Alberta, Canada.
“Until effective alternatives to the private car exist, driving will continue to be one of the most complex, vital and dangerous things we do. Everyone, not just those who may be medically at risk, would be well-advised to have their driving evaluated and to get more training,” said Dr. Scialfa. Although people with mild cognitive impairment can be safe drivers, “It is important to bear in mind that performance may change dramatically from one day to the next. Again, practice is critical,” Dr. Scialfa added.
This study is from “Predicting On-Road Driving Performance and Safety in Cognitively Impaired Older Adults.” It appears online ahead of print in the November 2015 issue of the Journal of the American Geriatrics Society. The study authors are Rachel W. Jones Ross, M.Sc.; Charles T. Scialfa, PhD, and Sheila T. D. Cordazzo, PhD, of the Department of Psychology, University of Calgary.