Objective Driving activity requires major involvement of executive functions. The main objective of our study was to determine whether mental flexibility and the updating of information in working memory are affected in drivers with mild to moderate Parkinson's disease (PD). Methods The study included 25 patients, aged 58e76, with mild to moderate PD and 25 healthy controls matched for age, sex and education, with an average mileage of over 3000 km/year. Neuropsychological tests were conducted to assess global cognitive abilities, to evaluate updating (via the n-back task), flexibility (via the pluseminus task) and information-processing speed (via the Stroop test). Three different scenarios were developed on a driving simulator. Participants were asked to recall road signs (updating task), indicate the shape or colour of road signs according to road side (flexibility task) and to brake at the same time as the car ahead (information-processing speed task) while driving.

Aims: Our purpose was to identify cognitive tools associated with unsafe driving among elderly drivers of varying cognitive levels. Methods: Twenty drivers with early-stage dementia of the Alzheimer type and 56 nondemented drivers aged 65–85 were recruited. Various cognitive processes were measured and unsafe driving was evaluated during an in-traffic road test with 3 different indicators and a composite indicator. Results: The Wechsler Digit Symbol Substitution Test score was the best cognitive measure to detect unsafe drivers using the composite driving indicator. Conclusion: The Digit Symbol Substitution Test may be used by physicians for the evaluation and follow-up of older patients, with or without Alzheimer-type dementia, as a screening tool of unsafe driving.

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