This report describes the final development and validation of an integrated three-tier system for assessing drivers’ degrees of driving wellness (degree of freedom from driving-relevant functional limitations) and driving fitness (degree to which a driver compensates for any such limitations while actually driving). Both driving wellness and driving fitness are assessed in a driving-centered manner. Assessment tools recommended for use in each tier are described, as is the selection of two decision points (cutpoints) which separate drivers into three categories: pass ("driving-well"), "somewhat functionally limited", and "extremely functionally limited." Compared to elder renewal license applicants who were assessed as somewhat functionally limited, elder renewals assessed as extremely functionally limited were more likely to fail a structured road test, but less likely to have been crash involved in the last three years. Reasons for this apparent paradox, in which more functionally limited drivers have fewer crashes, are addressed in the report. The report describes in detail the flow of renewal license applicants through the three-tier assessment system and makes numerous recommendations, including that the three-tier assessment system be adopted on a pilot basis for further evaluation. (Author/publisher)
Abstract