United States Department of Transportation
i
Mild Cognitive Impairment and Driving Performance
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2019-01-01
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[PDF-3.06 MB]
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Edition:Final Report
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Abstract:The objective of this project was to explore differences in driving performance and exposure between participants with mild cognitive impairment (MCI)-operationally defined through recognized clinical methods – and a comparison group of drivers of comparable age who did not meet those criteria. MCI refers to an intermediary, symptomatic state between age-appropriate cognitive decline and dementia. An initial literature review revealed a lack of clear boundaries between these cognitive status categories, which led researchers to consider continuous measures of cognitive impairment to predict road test performance and exposure. Thirty-eight participants were recruited. Clinical measures, administered by a certified driver rehabilitation specialist (CDRS), included the trail-making and maze tests, plus the Montreal Cognitive Assessment (MoCA). The Functional Activities Questionnaire (FAQ) was used to obtain participants' self-reports indicating cognitive status. A CDRS also administered the road tests in two study locations (in and near Roanoke and Richmond, Virginia). Exposure data were recorded with GPS loggers and cameras installed in participants' own vehicles for approximately one month. Regression models identified MoCA scores, and to a lesser extent Maze Test scores, as significant predictors of road test results, particularly with respect to tactical driving tasks. There were no significant regression models for analyses of exposure measures. Analysis of impairment status (not impaired, MCI, or moderate cognitive impairment) using only the MoCA classifications showed that those classified as unimpaired received significantly fewer points off on the on-road assessment than those classified as MCI, and this difference increased when comparing the unimpaired to those with any level of impairment. While the evidence was mixed regarding the extent to which MCI drivers appropriately self-restrict their exposure, MoCA appears to be a practical tool for occupational therapist generalists to use in identifying referrals for a comprehensive driving evaluation.
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Content Notes:Staplin, L., Lococo, K., Mastromatto, T., Gish, K. W., Golembiewski, G., & Sifrit, K. J. (2019, January). Mild cognitive impairment and driving performance (Report No. DOT HS 812 577). Washington, DC: National Highway Traffic Safety Administration.
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