TY - JOUR PY - 2016// TI - Comparison of a virtual older driver assessment with an on-road driving test JO - Journal of the American Geriatrics Society A1 - Eramudugolla, Ranmalee A1 - Price, Jasmine A1 - Chopra, Sidhant A1 - Li, Xiaolan A1 - Anstey, Kaarin J. SP - e253 EP - e258 VL - 64 IS - 12 N2 - 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

LA - en SN - 0002-8614 UR - http://dx.doi.org/10.1111/jgs.14548 ID - ref1 ER -