Self-rated driving performance among elderly drivers referred. for driving evaluation

Purpose: To explore whether elderly drivers of varying driving skill levels (1) differ in their perception of their driving evaluation performance and (2) determine if self-rated driving evaluation performance is related to cognitive ability. Methods: One hundred and fifty-two drivers aged 65 years or older and referred for a driving evaluation were enrolled into the study. Subjects were asked the question, how well do you think you will perform today on your driving evaluation compared to others your own age? Subjects also completed the Mini-Mental State Exam and a 30-min drive on a STISIM Drive (TM) simulation (Systems Technology, Inc., Hawthorne, CA). Only 47 subjects completed both the simulated drive and self-rated item. Results: Sixty-five percent of drivers rated themselves as performing better on a driving test than others of their age. Another 31.9% felt they would perform the same as others of their age on a driving test. A 50.0% of those considering themselves a little better and 52.9% of those considering themselves a lot better had an unsafe driving performance. As self-rated driving evaluation performance increased, there was a significantly increased risk of unsafe driving (p = 0.02) in the study population. Drivers who considered themselves at least a little better than others of their age were over four times more likely to be unsafe drivers compared to others who believed they were comparable to or worse than other drivers of their age (RR = 4.13, 95% CI = 1.08-15.78). There was no significant difference in MMSE between self-rating groups (p = 0.76). Conclusion: Older drivers assign high ratings to their driving performance, even in the presence of suspected skill decline. Cognitive ability was not related to self-rated driving evaluation performance. (c) 2005 Elsevier Ltd. All rights reserved.