The large increase in the number of elderly drivers holding a driving license highlights this population’s need for independent mobility. The ageing of the European population further increases the need for a fair and valid assessment system for older drivers. Hence, this deliverable presents a new integrated assessment methodology for elderly drivers as proposed by the AGILE project. The AGILE concept is a modular stepwise assessment approach for assessing the ability to drive of the elderly resulting in a motivated decision with regard to their fitness to drive, accompanied by suggestions concerning the driving license limitation, possible compensation/rehabilitation techniques, or alternative modes of transportation as ultimate resort. Since car driving is a very complex cognitive activity, even though many of its aspects are automated, and cognitive decline seems to account for a large part of the elderly traffic accidents, the assessment primarily aims at evaluating the cognitive functional status of the elderly driver. When cognitive decline is detected, the assessment further focuses on the detection of possible compensation mechanisms. Chapter 1 gives an overview of the current situation with regard to fitness to drive assessment of older drivers in- and outside Europe. Current initiatives in the USA, Oceania and Canada are introduced. Chapter 2 describes in detail the three-tiered AGILE assessment procedure. This procedure involves a medical pre-screening (tier 1a) to identify symptoms of age-related conditions with implications for functional skills relevant for driving. When such symptoms are diagnosed, a quick evaluation of functional skills is proposed during the screening phase (tier 1b). When scores are below specified thresholds, referral for further in-depth assessment at specialized centers (tier 2) is recommended, where functional deficits can be assessed through specific and extensive neuropsychological assessment. When a functional deficit considered important for safe driving is identified, a behind-thewheel test (tier 3) should determine if the functional decline can be compensated. Furthermore, the AGILE database to support the assessors in their decision-making is presented. Chapter 3 describes existing older driver rehabilitation courses and training schemes in- and outside Europe. This overview clearly shows that there is a lack of standardisation and studies to evaluate the long-term effects of participating in such programs. When driving cessation is insurmountable, it is necessary for older road users to change to other transportation means. Chapter 4 describes the alternative mobility schemes. The Deliverable ends with a brief conclusion in Chapter 5. The most important conclusion is that the AGILE methodology is an integrated and comprehensive approach, which is not limited to a unidimensional decision with regard to holding a driving licence. It takes also into consideration the right of mobility for all and the greater experience of elderly drivers who are often able to compensate for their deficits. Training rehabilitation programs are also proposed. (Author/publisher)
Abstract