Predicting Road Test Performance in Adults with Cognitive or Visual Impairment Referred to a Veterans Affairs Medical Center Driving Clinic

Authors


Address correspondence to Patricia M. Niewoehner, Veterans Affairs Medical Center, 1 Jefferson Barracks Drive, 117/JB, St. Louis, MO 63125. E-mail: pat.niewoehner@va.gov

Abstract

Objectives

To develop a screening battery for office-based clinicians that would assist with the prediction of impaired driving performance and deciding who should proceed to road testing in a sample of adults with cognitive or visual deficits.

Design

Prospective observational study.

Setting

Driving evaluation clinic at a Veterans Affairs Medical Center (VAMC) in St. Louis, Missouri.

Participants

Seventy-seven individuals aged 23 to 91 with diagnoses of cognitive or visual impairment or both referred to an occupational therapy based driving clinic by VAMC providers because of concerns regarding driving safety.

Measurements

Predictor variables included tests of visual and cognitive functioning and activities of daily living. The major outcome was pass or fail on a standardized performance-based on-road driving test.

Results

Thirty percent of the referrals failed the road test. The best predictors of driving performance were the Trail-Making Test Part A and the Mazes Test from the Neuropsychological Assessment Battery.

Conclusion

Measures of visual search, psychomotor speed, and executive functioning accurately predicted road test performance in a significant number of participants. These brief tests may assist clinicians in deciding who should proceed with a road test in a driver rehabilitation clinic or perhaps to whom it should be recommended to cease driving.

Ancillary