Neuropsychological assessment of fitness to drive following acquired cognitive impairment

PRIMARY OBJECTIVE: The study evaluated a neuropsychological assessment battery used to assess fitness to drive in cognitively impaired individuals and hypothesized that the battery would be associated with on-road outcome measures. A secondary aim was to explore the relationships between individual neuropsychological tests and driving performance. RESEARCH DESIGN: The study used a cross-sectional design in which a sample of individuals with various types of cognitive impairment completed the test battery and an on-road driving test. METHODS AND PROCEDURES: Performance on the test battery was compared to on-road driving performance in 104 individuals with acquired cognitive impairment. MAIN OUTCOMES AND RESULTS: The battery had 73% sensitivity and 76% specificity in terms of agreement with the 'pass/fail' classification of the on-road driving test. Scores on the battery accounted for 18% of the variance in the total number of corrective interventions performed by a driving instructor during the on-road test. Most tests correlated significantly with driving test outcomes. While one test, the Rey Complex Figure Test, emerged as an independent predictor of driving performance in multiple regression analyses, the variance explained by this single test was small. CONCLUSIONS: The results provide support for the use of a battery approach to assess fitness to drive.