Citation

Crizzle AM, Mullen N, Mychael D, Meger N, Toxopeus R, Gibbons C, Ostap S, Dubois S, Bedard M. Can. Geriatr. J. 2021; 24(1): 14-21.

Copyright

(Copyright © 2021, Canadian Geriatrics Society)

DOI

10.5770/cgj.24.444

PMID

33680259

Abstract

BACKGROUND: Studies have reported poor sensitivity and specificity of the Screen for the Identification of Cognitively Impaired Medically At-Risk Drivers, a modification of the DemTech (SIMARD-MD) to screen for drivers with cognitive impairment. The purpose of this study was to determine whether the SIMARD-MD can accurately predict pass/fail on a road test in drivers with cognitive impairment (CI) and healthy drivers.

METHODS: Data from drivers with CI were collected from two comprehensive driving assessment centres (n=86) and compared with healthy drivers (n=30). All participants completed demographic measures, clinical measures, and a road rest (pass/fail). Analyses consisted of correlations between the SIMARD-MD and the other clinical measures, and a receiver-operating-characteristic (ROC) curve to determine the predictive ability of the SIMARD-MD.

RESULTS: All healthy drivers passed the road test compared with 44.2% of the CI sample. On the SIMARD-MD, the CI sample scored significantly worse than healthy drivers (p <.001). The ROC curve showed the SIMARD-MD, regardless of any cut-point, misclassified a large number of CI individuals (AUC=.692; 95% CI = 0.578, 0.806).

CONCLUSIONS: Given the high level of misclassification, the SIMARD-MD should not be used with either healthy drivers or those with cognitive impairment for making decisions about driving.

Language: en

Keywords

dementia; sensitivity; specificity; older drivers; driving performance; cognitive impairment; comprehensive driving evaluation; SIMARD-MD