title: Error specific restrictions for older drivers: promoting continued independence and public safety.
abstract: OBJECTIVE
  To describe a population of older drivers with driving restrictions, their most common restrictions, and to compare restricted drivers to their safe and unsafe counterparts. Safe drivers are those who do not commit hazardous errors or traffic violations. Unsafe drivers are those who commit hazardous errors and/or traffic violations that place them in hazardous situations. Restricted drivers are those who have committed traffic or rule violations only under certain driving conditions.
  
  
  METHODS
  A retrospective, cross-sectional study with mixed methodology.
  
  
  METHODS
  A clinical driving evaluation program within an academic geriatrics department.
  
  
  METHODS
  Drivers age 60+ (N=108) referred for clinical driving evaluation and who consented to allow their data to be used for research purposes.
  
  
  METHODS
  Drivers performing at an intermediate level driving fitness were issued error specific driving restrictions.
  
  
  METHODS
  Driving evaluation included clock drawing test (CDT), mini-mental status exam (MMSE), Trailmaking, geriatric depression scale (GDS), and simulated driving.
  
  
  RESULTS
  The three most common restrictions were limited driving distance (N=8), limited driving time (N=8), and daytime only driving (N=8). Safe, restricted, and unsafe drivers significantly differed on MMSE (F[2,104]=10.75, p<0.001), Trailmaking Part B (F[2,76]=9.96, p<0.001), CDT (F[2,98]=29.88, p<0.001), and total number of hazardous errors (F[2,97]=39.06, p<0.001). Tukey's test indicated safe and restricted drivers scored significantly better than unsafe drivers on MMSE (safe: p<0.001; restricted: p=0.008), CDT (p<0.001), and hazardous errors (p<0.001). Restricted and unsafe drivers required significantly more time to complete Trailmaking B than safe drivers (p=0.004).
  
  
  CONCLUSIONS
  Preliminary data indicate restricted drivers perform more like safe than unsafe drivers. Driving simulation is instrumental in discerning error specific limitations and categorizing patients as conditionally safe. This clinical evaluation pilots an effective alternative to premature driving cessation.
authors.affiliation: The Glennan Center for Geriatrics and Gerontology, Eastern Virginia Medical School, 825 Fairfax: Avenue Suite 201, Norfolk, VA 23507, USA. freundbm@evms.edu
authors.forename: Barbara
authors.initials: B
authors.lastname: Freund
authors.forename: Leigh Anna A
authors.initials: LA
authors.lastname: Colgrove
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000331:legislation & jurisprudence* / Q000523:psychology*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008004:Licensure / Q000331:legislation & jurisprudence*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D013647:Task Performance and Analysis