title: Predicting road test performance in adults with cognitive or visual impairment referred to a Veterans Affairs Medical Center driving clinic.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Driving evaluation clinic at a Veterans Affairs Medical Center (VAMC) in St. Louis, Missouri.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Veterans Affairs Medical Center, St. Louis, Missouri 63125, USA. pat.niewoehner@va.gov
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Niewoehner
authors.forename: Rochelle R
authors.initials: RR
authors.lastname: Henderson
authors.forename: Jami
authors.initials: J
authors.lastname: Dalchow
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Beardsley
authors.forename: Robert A
authors.initials: RA
authors.lastname: Stern
authors.forename: David B
authors.initials: DB
authors.lastname: Carr
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001333:Automobile Driver Examination; D003072:Cognition Disorders / Q000503:physiopathology*; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012017:Referral and Consultation; D014481:United States; D014728:Veterans; D014786:Vision Disorders / Q000503:physiopathology*; D055815:Young Adult