Date Presented 04/22/2023
There is no standardized process to measure domains of cognition associated with driving. This poster reviews research regarding cognitive domains and assessments most predictive of fitness to drive and provides recommendations for practice.
Primary Author and Speaker: Laurie Steen
PURPOSE: Driving is a meaningful activity and important for independence, social participation, and quality of life. Cognitive impairments can impact a person’s ability to drive safely (Selander et al., 2019). There is no standardized process of cognitive assessments in fitness-to-drive evaluations. Clinicians may not be aware of the domains of cognition most predictive of performance. Thus, the purpose of this review was to understand research regarding cognitive domains and assessments most predictive of fitness-to-drive.
DESIGN: Literature review.
METHOD: Searched the databases CINAHL, PubMed, and Google Scholar (2004-2021) using search terms: Cognitive assessments, driving cessation, cognitive impairments, depression, driving safety. Synthesized the results of 10/93 identified studies.
RESULTS: Executive function (93%) and processing speed (86%) were most predictive of fitness to drive (Fields, et al., 2017), followed by visuospatial skills, attention, memory, and mental flexibility (79%), perception and concentration (71%). Cognitive assessments used for measuring these domains included TMT-A, TMT-B, Rey Figure Test, and UFOV. Language skills were least predictive of fitness to drive (<50%).
CONCLUSION: There is no standardized process used to measure all domains of cognition associated with driving. Executive function and processing speed are two domains of cognition most predictive of fitness-to-drive.
IMPACT STATEMENT: Driving cessation nearly doubles the risk of depressive symptoms in older adults (Ragland et al., 2005) so it is critical to be informed of evidence related to evaluating fitness-to-drive.
References
Fields, S. M., & Unsworth, C. A. (2017). Revision of the Competency Standards for Occupational Therapy Driver Assessors: An overview of the evidence for the inclusion of cognitive and perceptual assessments within fitness-to-drive evaluations. Australian Occupational Therapy Journal, 64(4), 328–339. https://doi.org/10.1111/1440-1630.12379
Ragland, D. R., Satariano, W. A., & MacLeod, K. E. (2005). Driving cessation and increased depressive symptoms. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 60(3), 399–403. https://doi.org/10.1093/gerona/60.3.399
Selander, H., Wressle, E., & Samuelsson, K. (2019). Cognitive prerequisites for fitness to drive: Norm values for the TMT, UFOV and NorSDSA tests. Scandinavian Journal of Occupational Therapy, 27(3), 231–239. https://doi.org/10.1080/11038128.2019.1614214
