Citation

Eramudugolla R, Price J, Chopra S, Li X, Anstey KJ. J. Am. Geriatr. Soc. 2016; 64(12): e253-e258.

Affiliation

Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australian Capital Territory, Australia.

Copyright

(Copyright © 2016, John Wiley and Sons)

DOI

10.1111/jgs.14548

PMID

27770585

Abstract

OBJECTIVES: To design a low-cost simulator-based driving assessment for older adults and to compare its validity with that of an on-road driving assessment and other measures of older driver risk.

DESIGN: Cross-sectional observational study. SETTING: Canberra, Australia. PARTICIPANTS: Older adult drivers (N = 47; aged 65-88, mean age 75.2). MEASUREMENTS: Error rate on a simulated drive with environment and scoring procedure matched to those of an on-road test. Other measures included participant age, simulator sickness severity, neuropsychological measures, and driver screening measures. Outcome variables included occupational therapist (OT)-rated on-road errors, on-road safety rating, and safety category.

RESULTS: Participants' error rate on the simulated drive was significantly correlated with their OT-rated driving safety (correlation coefficient (r) = -0.398, P =.006), even after adjustment for age and simulator sickness (P =.009). The simulator error rate was a significant predictor of categorization as unsafe on the road (P =.02, sensitivity 69.2%, specificity 100%), with 13 (27%) drivers assessed as unsafe. Simulator error was also associated with other older driver safety screening measures such as useful field of view (r = 0.341, P =.02), DriveSafe (r = -0.455, P <.01), and visual motion sensitivity (r = 0.368, P =.01) but was not associated with memory (delayed word recall) or global cognition (Mini-Mental State Examination). Drivers made twice as many errors on the simulated assessment as during the on-road assessment (P <.001), with significant differences in the rate and type of errors between the two mediums.

CONCLUSION: A low-cost simulator-based assessment is valid as a screening instrument for identifying at-risk older drivers but not as an alternative to on-road evaluation when accurate data on competence or pattern of impairment is required for licensing decisions and training programs.

© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Language: en