The objective of this retrospective cohort study was to evaluate the effectiveness of crash history, family concerns, clinical condition, and cognitive function (the 4Cs, an interview-based screening tool for health providers working with older drivers) in identifying at-risk older drivers. Setting was a clinical driving evaluation program at a teaching hospital in the United States. Participants were one hundred sixty patients who completed comprehensive driving evaluations between 2003 and 2009. Medical record information was used to identify component and total 4Cs scores. Other measurements included the Trail Making Test, the Mini-Mental State Examination, and brake reaction time. The outcome variable was performance on a 45-minute road test. Fifty participants passed the road test, 67 failed, and 43 demonstrated marginal driving skills. The relationship between 4Cs scores and road test outcome was statistically significant (P<.001). The domains most strongly associated with road test outcome were cognitive function (P<.001) and family concerns (P=.01). Scores of 9 or greater-on the 4Cs identified 84% of participants who were at risk for poor road test performance. The 4Cs, an interview based screening tool, may be a useful marker to identify at-risk older drivers. (Author/publisher)
Abstract