Abstract
Fitness to drive after acquired brain injury or disease is a common question in rehabilitation settings. The aim of the study was to compare age-matched norms with patient cognitive test results used to predict fitness to drive. A second aim was to analyze the contribution from an on-road assessment to a final decision on resumption of driving after an acquired brain injury. Retrospective cognitive test results from four traffic medicine units (n = 333) were compared with results from a healthy norm population (n = 410) in Sweden. Patients were dichotomized according to the final decision as fit or unfit to drive made by the traffic medicine team. The norm group had significantly better results in all age groups for all cognitive tests compared with the patients considered unfit to drive and fit to drive. A binary regression analysis for the patient group showed an explained value for fit to drive/unfit to drive of 88%, including results for the Nordic Stroke Driver Screening Assessment total score, Useful Field of View total score and the final outcome from an on-road assessment. Results from the present study illustrate the importance of using several tests, methods and contexts for the final decision regarding fitness to drive.
Highlights
Seventy-eight percent of the population in Sweden (18 years and older) have a driver’s license
In addition to an impaired cognitive function after an acquired brain injury (ABI), which might affect driving ability (Vickers, Schultheis & Manning, 2018), age has been shown to have an effect on safe driving
There was no difference in the results on any of the cognitive tests (p = 0.24) or for the final decision in the patient group (v2 = 0.15, p = 0.076, Yates correction)
Summary
Seventy-eight percent of the population in Sweden (18 years and older) have a driver’s license. For most individuals, driving is a symbol of independence and a prerequisite for an active lifestyle, self-esteem and quality of life and of great importance (Adler & Rottunda, 2006). It is important for clinical psychologists and occupational therapists to make a thorough assessment and include an individual perspective in decisions about continued driving after an injury or disease affecting the brain. In addition to an impaired cognitive function after an acquired brain injury (ABI), which might affect driving ability (Vickers, Schultheis & Manning, 2018), age has been shown to have an effect on safe driving. Old (>75 years) as well as young people (18–24 years), but for different reasons, have been found to have five to six times higher risk of causing and/or dying from a traffic accident, compared with middle-aged groups (Trafa, 2019); this should be taken into account in driving assessment.
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