Research Article
Issue Date: July/August 2018
Published Online: May 22, 2018
Updated: April 30, 2020
Predictive Value of the Cognitive Performance Test (CPT) for Staging Function and Fitness to Drive in People With Neurocognitive Disorders
Theressa Burns; Katie Lawler; David Lawler; J. Riley McCarten; Michael Kuskowski
Author Affiliations
  • Theressa Burns, BS, OTR, is Clinical Occupational Therapist Specialist, Geriatric Research Education and Clinical Center, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN; theressa.burns@va.gov
  • Katie Lawler, MA, OTR/L, DRS, is Driving Rehabilitation Specialist, Geriatric Research Education and Clinical Center, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN
  • David Lawler, MA, OTR/L, CDRS, is Certified Driving Rehabilitation Specialist, Physical Medicine and Rehabilitation, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN
  • J. Riley McCarten, MD, is Co-Acting Director and Medical Director, Geriatric Research Education and Clinical Center, Minneapolis Veterans Affairs Medical Center, and Associate Professor, Department of Neurology, University of Minnesota Medical School, Minneapolis
  • Michael Kuskowski, PhD, is Biostatistician, Geriatric Research Education and Clinical Center, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN
Article Information
Alzheimer's Disease and Dementia / Community Mobility and Driving / Neurologic Conditions / Rehabilitation, Participation, and Disability / Research Articles
Research Article   |   May 22, 2018
Predictive Value of the Cognitive Performance Test (CPT) for Staging Function and Fitness to Drive in People With Neurocognitive Disorders
American Journal of Occupational Therapy, May 2018, Vol. 72, 7204205040. https://doi.org/10.5014/ajot.2018.027052
American Journal of Occupational Therapy, May 2018, Vol. 72, 7204205040. https://doi.org/10.5014/ajot.2018.027052
Abstract

The Cognitive Performance Test (CPT) is a standardized occupational therapy assessment that examines cognitive integration with functioning in an instrumental activities of daily living context. Conventional cognitive measures provide diagnostic utility but do not fully address the functional implications. Ninety-one veterans diagnosed with cognitive impairment were evaluated. We compared the predictive value of the CPT with the Large Allen Cognitive Level Screen (LACLS), Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA) for the need to retire from driving versus ability to pass an on-road exam. Measures were also analyzed by diagnostic classification. CPT correctly classified a mild versus major neurocognitive disorder, whereas MMSE, MoCA, and LACLS did not differentiate the groups. A CPT cutoff score of <4.7/5.6 showed 89% sensitivity for failing the road exam and 75% specificity for ability to pass. CPT discriminated functional level in neurocognitive disorders and had better predictive value for fitness to drive compared with conventional cognitive measures.