Abstract

Cognitive decline resulting from Dementia of Alzheimer’s Type (DAT) can lead to reduced ability to perform complex daily tasks required for independent living, including driving an automobile. This study explores the ability of untrained observers to classify driving safety using short video clips of simulated driving through intersections; it also examined whether untrained observers could predict whether the driver was cognitively healthy or cognitively impaired. Participants (n = 54) were shown a series of 30 video clips arranged in an online survey and asked to answer questions following each clip regarding the safety of the maneuver and the cognitive status of the driver. Results showed that participants’ subjectively rated DAT drivers as significantly less safe in comparison to control drivers, F (1, 52) = 228.44, p < 0.001. Participant’s classification of DAT drivers and controls was also significantly higher than chance (i.e., >50% correct). Findings provide preliminary support for the development of a clinical decision-making aid using video replay of driving simulator performance in fitness-to-drive assessments for individuals with cognitive impairment.

Highlights

  • Driving requires a wide range of cognitive abilities including integrating sensory information from multiple sources, perceptual and spatial processing, motor skills, decision making, and planning [1]

  • Even if the level of risk is greater in older individuals living with dementia, research supports the argument that a diagnosis of dementia should not be the sole basis for revoking driving privileges [4,5]

  • The purpose of this study is to test the use of short driving simulator video clips of maneuvers deployed at intersections as a means to facilitate the determination of driving safety

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Summary

Introduction

Driving requires a wide range of cognitive abilities including integrating sensory information from multiple sources, perceptual and spatial processing, motor skills, decision making, and planning [1]. The cognitive decline associated with DAT leads to a decreased ability to perform complex tasks required for independent living, such as driving. Even if the level of risk is greater in older individuals living with dementia, research supports the argument that a diagnosis of dementia should not be the sole basis for revoking driving privileges [4,5]. This is especially crucial in regard to the importance of driving and mobility for many older individuals. It is of critical importance to balance the potential harms associated with driving cessation with the potential increases in risk to safety when considering fitness-to-drive decisions for persons with dementia

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