COGNITIVE/NEUROPSYCHOLOGICAL FUNCTIONING AND COMPENSATION RELATED TO CAR DRIVING PERFORMANCE IN OLDER ADULTS

The objective of this research project was to put together a multidimensional concept in order to gain more insight into the relation between the cognitive/neuropsychological factors, compensation mechanisms and safe car driving performance of older adults. The research sample consisted of 84 car drivers over 65 years of age, who were referred by their doctor or insurance company for a general fitness-to-drive evaluation. The study started with the development of an easy-to-administer short screening battery that can be used as a first-tier assessment tool in primary health care settings. Analyses revealed the potential value of such an instrument to identify people in need of further fitness-to-drive evaluation. Subsequently, detailed top-down theory-driven hypotheses were tested regarding the correlation between cognitive/neuropsychological functioning and car driving performance. Correlations between specific neuropsychological tests and self-reported accidents were investigated. Furthermore, the correlations between the same tests and a road test, independently assessed on a detailed evaluation grid, were analysed in depth. The results of this study highlight the relevance of a cognitive/neuropsychological approach to the driving ability of elderly people. However, the link with accident risk was found to be more complex. A detailed accident analysis was therefore carried out which revealed that this type of analysis taking into account the specific accident type could enhance the predictive value of neurocognitive measurements. Finally, the influence of compensation strategies was analysed in depth. The results of these analyses revealed that tactical and strategic compensation can be successful in helping persons with obvious driving problems avoid accidents. Consequently, neuropsychological screening procedures are in need of a broader perspective to prevent overemphasis on unidimensional screening procedures focusing more on deficits than on the ability to adopt safe compensatory behaviour patterns. For the covering abstract see ITRD E113725.

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