An analysis of an older driver evaluation program.
OBJECTIVE
To identify elements of an older driver evaluation program that predict driving performance in older adults.


METHODS
Outpatient medical clinic in an academic medical center.


METHODS
A retrospective analysis.


METHODS
Six hundred sixty-four older adults who were referred to an older driver evaluation program.


METHODS
A physician trained in geriatric medicine and a clinical geriatric nurse specialist oversaw an experienced driving evaluator and an occupational therapist who conducted assessments of older persons' functional status; reaction time; driving skills; and cognitive, hearing, and vision abilities. Self-report data along with a medical history submitted by patients' primary care physicians supplemented the clinical assessments.


RESULTS
A multinomial logistic regression revealed that the Mini-Mental State Examination (MMSE), cues needed with the Trail Making Test, Part B, grip strength, and an interaction effect between the MMSE and reaction time constituted the most parsimonious model for predicting on-the-road performance. A receiver operating characteristic analysis indicated that this index had good sensitivity but low specificity. A binomial regression comparing imperfect and perfect drivers demonstrated the significance of the Traffic Sign and Visual Perception tests.


CONCLUSIONS
Clinicians should employ a multilevel screening process that includes initial cognitive tests, such as the MMSE and the Trail Making Test, Part B, although more studies of driving evaluation programs in medical settings that include random samples of older drivers are needed.
Office of Geriatrics and Gerontology, College of Health Sciences, Ohio State University, Columbus, Ohio 43210, USA.
Bonnie
B
Kantor
Linda
L
Mauger
Virginia E
VE
Richardson
Kathleen Tschantz
KT
Unroe
D000368:Aged; D001334:Automobile Driving; D003071:Cognition; D005260:Female; D018737:Hand Strength; D006320:Hearing Tests; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D012372:ROC Curve; D011930:Reaction Time; D012189:Retrospective Studies; D014145:Trail Making Test; D014796:Visual Perception