Towards a cognitive assesment of senior drivers' fitness to drive

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Michael Hull

The increasing mean age of populations of developed and developing countries, combined with the increasing numbers of drivers entering the older age groups does not allow future elevated crash numbers to be ignored. In many regions, older drivers are required to undertake tests of vision and to provide medical certification of their continued capacity to drive. The literature suggests that such tests are expensive and have little capacity to identify those at higher risk and therefore unjustifiably discriminate against older drivers.

Both to contain expense in ageing societies and to minimise disruption to those still capable of driving safely, a reliable screening tool is required. Such a tool should be capable of administration by sub-professional personnel; it should be quick to complete and require a minimum of instructions and supervision. Thus far, the most promising such test is the Useful Field of View Test, widely reported on by Ball, Owsley and others. But lay people and judicial tribunals may fail to perceive the relevance of such a test to the driving task.

An alternative approach may derive from an adaptation of the Hazard Perception Test, variations of which are currently used in several Australian States to assess novice drivers. This approach uses computer-generated video scenes of traffic situations and requires of subjects a simple binary response. This paper summarises an evaluation such a test on older drivers, with a control group and an experimental group referred for occupational therapist assessment because of official doubts about their ability to drive safely. Analysis demonstrates that the test discriminates between older drivers in these groups. Further development may well provide an acceptable and efficient tool for identifying older drivers whose driving should be curtailed.

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