title: Health-adjusted neuropsychological test norms based on 463 older Swedish car drivers.
abstract: There is a need for improved normative information in particular for older persons. The present study provides neuropsychological test norms on seven cognitive tests used in a sample representing the general older driving population, when uncontrolled and controlled for physical health. A group of 463 healthy Swedish car drivers, aged 65 to 84 years, participated in a medical and neuropsychological examination. The latter included tests of visual scanning, mental shifting, visual spatial function, memory, reaction time, selective attention, and simultaneous capacity. Hierarchical regression analyses demonstrated that, when uncontrolled for health, old age was associated with significant impairment on all seven tests. Education was associated with a significant advantage for all tests except most reaction time subtests. Women outperformed men on selective attention. Controlling for health did not consistently change the associations with education, but generally weakened those with age, indicating rises in normative scores of up to 0.36 SD (residual). In terms of variance explained, impaired health predicted on average 2.5%, age 2.9%, education 2.1% and gender 0.1%. It was concluded (1) that individual regression-based predictions of expected values have the advantage of allowing control for the impact of health on normative scores in addition to the adjustment for various demographic and performance-related variables and (2) that health-adjusted norms have the potential to classify functional status more accurately, to the extent that these norms diverge from norms uncontrolled for physical health.
authors.affiliation: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden.|Traffic Medicine Centre, Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Ingvar
authors.initials: I
authors.lastname: Bergman
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden.|Traffic Medicine Centre, Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Kurt
authors.initials: K
authors.lastname: Johansson
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden.|Department of Psychology, Stockholm University, Stockholm, Sweden.
authors.forename: Ove
authors.initials: O
authors.lastname: Almkvist
authors.affiliation: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden.|Traffic Medicine Centre, Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Catarina
authors.initials: C
authors.lastname: Lundberg
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001288:Attention; D001334:Automobile Driving / Q000523:psychology / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011930:Reaction Time; D012737:Sex Factors; D013548:Sweden
keywords: Cognitive aging; fitness to drive; normal adults; normative data; physical health; regression-based norms