Predicting on-road driving performance and safety in healthy older adults

• The Roadwise Review, a Hazard Perception Test and several tests of vision were given to 65 cognitively healthy older drivers.
• They also participated in a standardized driving assessment.
• The best model for predicting passing or failing the on-road assessment included the HPT, color vision, and walking speed.
• Future work will need to determine how these tests can be used to yield better diagnoses of fitness to drive.

Introduction: This study evaluated the ability to predict the on-road driving of older drivers using a battery of laboratory-based instruments. Methods: The Roadwise Review, a brief Hazard Perception Test and several tests of vision were given to 65 cognitively healthy, licensed older drivers (M = 74 years, SD = 9 years). They also participated in a standardized driving assessment of approximately 18 km, along a mixed residential and commercial route. Results: Raw scores on the Roadwise Review did not predict accumulated points, or automatic disqualifications, but could predict who would pass or fail the on-road evaluation. The number of serious problems (excluding head and neck flexibility) that were identified by the Roadwise Review was a significant predictor of automatic disqualifications, and a significant predictor of passing or failing the on-road assessment. The Hazard Perception Test approached significance when predicting accumulated points and was a significant predictor of automatic disqualifications, as well as pass/fail outcomes. Conclusions: The best model for predicting passing or failing the on-road assessment included the Hazard Perception Test, color vision, and, a measure of walking speed from the Roadwise Review, which yielded a sensitivity of 82% and a specificity of 69% (AROC = .80). Future work will need to determine how these tests can be used with other information (e.g., medical history) to yield better diagnoses of fitness to drive, particularly among those who are medically at risk.