Driving Performance and Its Correlation with Neuropsychological Tests in Senior Drivers with Cognitive Impairment in Japan

Abstract

Background: With the rapid aging of the population, the issue of driving by dementia patients has been causing increasing concern worldwide. Objective: To investigate the driving difficulties faced by senior drivers with cognitive impairment and identify the specific neuropsychological test that can reflect specific domains of driving maneuvers. Methods: Senior drivers with cognitive impairment were investigated. Neuropsychological tests and a questionnaire on demographic and driving characteristics were administered. Driving simulator tests were used to quantify participants’ driving errors in various domains of driving. Results: Of the 47 participants, 23 current drivers, though they had better cognitive functions than 24 retired drivers, were found to have impaired driving performance in the domains of Reaction, Starting and stopping, Signaling, and Overall (wayfinding and accidents). The parameters of Reaction were significantly related to the diagnosis, and the scores of MMSE, TMT-A, and TMT-B. As regards details of the driving errors, “Sudden braking” was associated with the scores of MMSE (ρ= –0.707, p < 0.01), BDT (ρ= –0.560, p < 0.05), and ADAS (ρ= 0.758, p < 0.01), “Forgetting to use turn signals” with the TMT-B score (ρ= 0.608, p < 0.05), “Centerline crossings” with the scores of MMSE (ρ= –0.582, p < 0.05) and ADAS (ρ= 0.538, p < 0.05), and “Going the wrong way” was correlated with the score of CDT (ρ= –0.624, p < 0.01). Conclusion: Different neuropsychological factors serve as predictors of different specific driving maneuvers segmented from driving performance.

Alterations in driving ability and their relationship with morphometric magnetic resonance imaging indicators in patients with amnestic mild cognitive impairment and Alzheimer's disease

“…Previous studies reported that patients with mild AD performed significantly worse than those with MCI in a simulated driving test. 11,18,19 The results of the current study also indicate that a negative influence on the ability to drive in patients with AD who progressed from aMCI can be detected by a driving simulator. There was a significant negative correlation between reaction time variability in the selective reaction test and the total MMSE scores.…”

“…An increase in simple reaction time in MCI and AD 25 and a positive correlation between slow reaction speed and GM loss in AD 26 have been reported. It has been reported that delayed driving reactions are associated with decreased MMSE scores 11 and increased risk of traffic accidents. 12 A positive correlation has been reported between the variability of performance on neuropsychological tests and GM atrophy in human immunodeficiency virus patients.…”

“…7,8 To evaluate the driving abilities of elderly drivers with declining cognitive function, studies have been conducted using neuropsychological tests, 9 caregiver interviews, 10 driving simulators, 11,12 road tests, 13 and neuroimaging. 14 In studies using driving simulators, the reaction time was associated with the Mini-Mental State Examination (MMSE) score, 11 and the reaction time of lower extremities was longer in the group that had experienced a traffic accident. 12 In a study using magnetic resonance imaging (MRI) and road test, atrophy of the left hippocampus was associated with poor lane control in MCI.…”

Speedometer‐reading performance of senior drivers with cognitive impairment: a comparison of analogue and digital speedometers

“…The participant scores for Mini‐Mental State Examination (MMSE), trail‐making test (TMT), block design test (BDT), Alzheimer's Disease Assessment Scale–cognitive subscale (ADAS‐Cog), the clock‐drawing test (CDT), and logical memory (LM) I and II (subtests of the Wechsler memory scale‐revised (WMS‐R)) were collected. The details of these neuropsychological tests were described in our previous study 32 …”

The Effects of Cognitive Training on Driving Performance

“…These domains, ranging from attention and memory to visuospatial skills and executive functions, are interlinked with the brain's complex architecture. For instance, attention allows drivers to continuously monitor the road, quickly detect hazards, avoid distractions, and has been shown to correlate with driving performance metrics such as lane keeping and hazard detection times (Khan et al, 2018;Peng et al, 2021;Ross et al, 2014;Uc et al, 2006;Yi et al, 2015). Memory supports learning and retrieving driving knowledge, recognizing routes, and recalling traffic rules (Scott et al, 2023).…”