Meta-analysis of cognitive screening tools for predicting unsafe behaviour among elderly drivers

摘要

Seniors represent the fastest growing population group in Canada, as in many other countries. Given the expected increase in elderly drivers with cognitive impairments, efficient and effective screening for impairment will become more important. In light of this need, the objective of this study was to systematically review and meta-analyze the literature for brief non-computerized cognitive screens that were evidenced-based and could be easily adopted in a driver license renewal setting to determine their predictive value to identify unsafe driving behaviors. Relevant studies for this meta-analysis were identified by means of a systematic review of the literature. There was an initial selection of 446 articles which were screened using inclusion criteria into a final sample of nine articles with 15 evaluations that identified 10 different pencil-and-paper tools. A meta-analysis of evaluations of cognitive screening tools which measure driving performance through a road test, driving simulator assessment or motor vehicle crashes was conducted. A small to medium-sized, significant pooled effect of 1.94 was found, meaning that on average, when cognitive screening tools predict a driver is unsafe, there is a 94% greater chance that this driver will indeed exhibit unsafe driving behavior, rather than safe driving behavior. Driving license authorities may consider adopting non-computerized cognitive screening tests since they are brief, low cost, require minimal training, are relatively easy to administer and may assist with driving fitness recommendations.