Sherrilene Classen; Special Issue on Older Driver Safety and Community Mobility. Am J Occup Ther 2010;64(2):211-214. doi: 10.5014/ajot.64.2.211.
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© 2018 American Occupational Therapy Association
Test route standardization should be studied.
Reliability and validity should be improved in driving assessment procedures.
Driving-related professional training should be aimed at enhancing professionals' capacity in assessment and intervention.
Improve congruence between the vehicle and safety feature design and seniors' needs.
Specific aspects of vehicle design, safety features, and action strategies that support safer use and operation of a vehicle by seniors are outlined.
In driving and dementia, examine wandering, consequences of becoming lost while driving, and reasons of why some drivers with dementia become lost whereas others may not need to be studied.
Arthritis and Driving Toolkit contains strategies to support safe mobility for people with arthritis.
People with hemianopia or quadrantopia may continue to drive and need an on-road driving evaluation.
Older female drivers emerged as a high-risk group for crash-related injury, and research efforts must find protective strategies to make them less vulnerable as a group.
Lane maintenance, yielding, and gap acceptance errors are critical driving errors because they predict crash-related injuries with almost 50% probability.
The strongest predictors of failing an on-road test are adjustment to stimuli and lane maintenance errors.
A decision tree was developed to inform driving evaluators' clinical decision making on type of driving errors made.
Further research is required to develop the Australian Occupational Therapy Driver Off-Road Assessment battery as a valid and reliable measure of driver skill.
The University of Florida's on-road assessment predicts drivers passing/failing an on-road course with 91% sensitivity and 87% specificity.
The Cognitive Behavioral Driver's Inventory should not be used as a substitute for an on-road test.
A self-report Safe Driving Behaviors Measure for use by older drivers, their caregivers, or generalist/specialist occupational therapists was developed by the University of Florida researchers.
Research is needed on test acceptability, because it may have the potential to increase understanding or compliance with recommendations.
Research is also needed to examine client confidence levels and the potential impact on performance during the driving evaluation process.
In general, older adults are more accepting of tests with relevance to driving performance (e.g., Neuropsychiatric Assessment Battery and the Washington University Road Test) than other off-road measures.
Likewise, confidence of older adults decreases after administration of a psychometric test battery, but confidence increases after the on-road evaluation.
Feasibility studies and follow-up randomized controlled studies should be conducted to support the use of simulators as predictors of on-road driving performance.
In healthy senior drivers, simulator sickness does not prevent examination of those who need it most (i.e., those with the poorest on-road driving performance), and cognitive differences are not associated with dropping out because of simulator sickness.
With adequate training, occupational therapists could use simulators to facilitate their decision-making regarding fitness to drive.
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