Neuropsychological assessment of geriatric driving competence

Primary objective: To review of studies that focus on the assessment of driving competence among the elderly who are at increased risk of being involved in automobile crashes. The current status of neuropsychological testing as a predictor of driving safety in this population is critically evaluated. Main outcomes and results: Several domains of neuropsychological assessment have been shown to be related to safe driving in older age groups, including vision- based testing, attention- based testing, and testing of executive functions. Use of a driving simulator to investigate crash risk has been particularly effective. Conclusions: The argument is made that a combination of test approaches be used to develop an algorithm for efficient screening of elderly drivers on a regular basis and that use of a driving simulator to measure driving performance under challenge should be incorporated as part of this evaluation.