Findings from a report by Professor Ngaire Kerse and Dr Ruth Teh, Department of General Practice and Primary Health Care, University of Auckland confirms Grey Power’s concerns regarding the unproven value of cognitive tests to assess seniors’ driving ability. Commissioned by NZ Transport Agency Waka Kotahi (NZTA) and the Office for Seniors, it aims to help health professionals understand the usefulness of cognitive assessment within a medical office-based assessment process.
Senior motorists in New Zealand will likely be relieved to learn that current evidence does not support the routine use of a cognitive assessment as part of a ‘fitness to drive’ assessment for older people who are considered to be physically and mentally healthy.
Although age is the strongest risk factor for cognitive impairment, the report finds that, currently, there is no universally accepted protocol for a GP or nurse practitioner to use cognitive tests in a’ fitness to drive’ assessment. Neither is there a universally accepted cognitive test for assessing fitness to drive.
Because driving is a complex, mentally demanding activity, the research finds no single cognitive assessment accurately represents driving
performance.
A person’s health remains an important consideration, as well as information from support people and others about driving safety, prior crash history, minor collisions or near miss events.
The report finds these factors should be considered in conjunction with all aspects of NZTA’s Medical aspects of fitness to drive, a guide for health practitioners, refer to
www.nzta.govt.nz.
When an assessor is uncertain about an individual’s capacity to drive safely for cognitive or functional reasons, then an On-Road Safety Test (ORST), alongside other medical assessments, may give a more complete indicator of driving ability.
The ORST is a FREE, on-road practical driving assessment available throughout New Zealand and booked through participating offices of VTNZ, VINZ and the AA.
Alternately, where the main concern is about cognitive deficit, an Occupational Therapy Driving Assessment can give more specific information about the impact of cognition on driving ability and may assist with making recommendations about driving restrictions or giving up driving altogether. [The cost of this test may be in the vicinity of $800 – $1500].
Whilst this review is primarily focused on cognitive assessment, visual clarity and standard vision assessment, it finds that health stability, basic dexterity and foot and lower limb ability remain relevant.
In recognising there is no perfect office-based test, the report recommends that if there is uncertainty of cognitive or functional ability to drive, then an ORST or, if appropriate, an Occupational Therapy Driving Assessment, will add useful information.
