(1994) later examined 30 older drivers with a range of cognitive function including dementia on a combined closed course and open-traffic course, demonstrating a significant relationship between performances in the two environments. Carr, Jackson, Madden, and Cohen (1992) demonstrated stability of driving skills for older drivers using a low-intensity standardized road test on a college campus. Road test designs make comparisons across studies difficult, and differences include the number of assessors in the vehicle, scoring procedures, and the environment, duration, and course ( Wheatley & Di, 2008).Ī large number of research studies have used road tests as an outcome measure in neuropsychological studies attempting to define a screening tool for impaired driving. These factors include, but are not limited to, uncontrollable environmental factors within or across courses (e.g., changes in traffic density, course familiarity), driver experience (e.g., occupations that require driving at a very high skill level), driver intrinsic factors (e.g., personality traits, lifelong driving habits, test-taking anxiety, fatigue), and assessor differences (e.g., training, biases, experience). However, the validity of this approach in the special population of cognitively impaired older drivers has not been as rigorously evaluated.Ī wide range of variables may affect the reliability and validity of the road test. Test characteristics for on-road driving tests in elders without dementia show good interrater and test–retest reliability, internal consistency, and correlation between global and total performance scores in research settings ( DiStefano & Macdonald, 2003 Justiss, Mann, Stav, & Velozo, 2006 Kay, Bundy, Clemson, & Jolly, 2008). Given this apparent face validity, road testing has been widely adapted as a tool to assess driving competence of older people who may be at risk for unsafe driving because of accompanying medical illnesses, such as dementia ( Carr & Ott, 2010). Road testing has long been a time-honored national standard for licensing new drivers. A major risk factor for hazardous driving in the elderly is cognitive impairment.
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