The identification of unsafe older drivers is a current and important challenge. As already stated in AGILE deliverables (AGILE D1.1; AGILE D6.1) for the majority of older drivers, it is unlikely that the effects of age, per se, are of sufficient magnitude to account for many crashes in elderly drivers. Several literature findings show that age is a poor predictor of crash rates (e.g. Transportation Research Board, 1988). Research has also revealed that common medical examination could not distinguish between safe and unsafe drivers as it is insensitive to cognitive decline which showed to be more related with driving problems (Eeckhout and Arno, 2002). However, driving-related cognitive impairment is difficult to estimate in a consulting room or a primary health care setting. Through a systematic and integrated solution, AGILE proposes to follow a modular step-by-step assessment approach, which consists of screening cognitive status in a first tier followed by an in-depth assessment for older drivers detected as being possibly at-risk in a second tier. As a consequence, full assessment is reduced to difficult cases only. In a consulting room or primary health care setting, the use of a short test battery would help the medical doctor to decide which older drivers should be referred to a specialized driving assessment center. The purpose of such a battery should not be to use it as a conclusive instrument but as a first indicator for further referral. The AGILE deliverable D3.1 aims to describe the rationale and development of the pre-screening tool to be used in a first tier of the AGILE driving assessment procedure. This deliverable is composed of three main parts. The first part gives a synthesis of the major publications about the development of screening assessment batteries intended to predict driving performance of older drivers. Some methodological issues are then underlined. This leads us to expose the specific objectives AGILE has been pursuing with the development of a screening assessment battery. The second part describes the content of the AGILE screening battery. Basically, it is composed of a well-known cognitive test (Trail Making Test (TMT), part A, Reitan et al. 1957), a questionnaire of Instrumental Activities of Daily Living, and a newly developed attention-based computer test. The way the IADL questionnaire is selected as well as the development of the new tool is explained. The third part presents the new computerized test itself. (Author/publisher)
Samenvatting