Identifying older drivers at risk of traffic violations by using a driving simulator: a 3-year longitudinal study.

OBJECTIVES This prospective longitudinal study aims to determine which simulated driving tasks of a personal computer (PC)-based driving simulator can be used to identify problematic older drivers, using their 3-year driver violation points record as the outcome measure. METHODS A total of 129 urban community-dwelling older drivers volunteered to participate in the study. Using a driving simulator, specific driving tasks were devised to test the performance of older drivers. Their officially recorded driver violation points were retrieved immediately after the simulated driving assessment and thereafter for the following 2 years. Self-reported driving records were also collected during the same period. Hierarchical Poisson regression analysis, adjusting for gender, age, and driving exposure (hours of driving per week), was then undertaken to determine those driving tasks that affected the frequency of traffic violations. RESULTS All participants incurred at least one driver violation point during the 3-year period. The simulated driving tasks found to be significantly associated with the incidence of traffic violations were working memory and use of indicator. CONCLUSIONS This longitudinal study demonstrated that the driving simulator was able to identify unsafe older drivers at risk of traffic violations if appropriate simulated driving tasks were used. Such a screening tool should be adopted prior to administering a more detailed but expensive road test.