Using Serial Trichotomization with Neuropsychological Measures to Inform Clinical Decisions on Fitness-to-Drive among Older Adults with Cognitive Impairment

Occup Ther Health Care. 2024;38(1):5-25. doi: 10.1080/07380577.2020.1843750. Epub 2020 Nov 28.

Abstract

Decisions related to driving safety and when to cease driving are complex and costly. There is an interest in developing an off-road driving test utilizing neuropsychological tests that could help assess fitness-to-drive. Serial trichotomization has demonstrated potential as it yields 100% sensitivity and specificity in retrospective test samples. The purpose of this study was to test serial trichotomization using four common neuropsychological tests (Trail Making Test Part A and B, Clock Drawing Test, and Modified Mini-Mental State Examination). Test scores from 105 patients who were seen in a memory clinic were abstracted. After applying the model, participants were classified as unfit, fit, or requiring further testing, 38.1%, 25.8%, and 36.1%, respectively. This study provides further evidence that trichotomization can facilitate the assessment of fitness-to-drive.

Keywords: Driving cessation; fitness-to-drive; neuropsychological tests; older adults; trichotomization.

MeSH terms

  • Aged
  • Automobile Driving* / psychology
  • Cognitive Dysfunction*
  • Humans
  • Neuropsychological Tests
  • Occupational Therapy*
  • Retrospective Studies