Prediction of driving ability with neuropsychological tests: demographic adjustments diminish accuracy

J Int Neuropsychol Soc. 2010 Jul;16(4):679-86. doi: 10.1017/S1355617710000470. Epub 2010 May 5.

Abstract

Demographically adjusted norms generally enhance accuracy of inferences based on neuropsychological assessment. However, we hypothesized that demographic corrections diminish predictive accuracy for real-world activities with absolute cognitive demands. Driving ability was assessed with a 45-minute drive along a standardized on-road route in participants aged 65+ (24 healthy elderly, 26 probable Alzheimer's disease, 33 Parkinson's disease). Neuropsychological measures included: Trail-Making A and B, Complex Figure, Benton Visual Retention, and Block Design tests. A multiple regression model with raw neuropsychological scores was significantly predictive of driving errors (R2 = .199, p = .005); a model with demographically adjusted scores was not (R2 = .113, p = .107). Raw scores were more highly correlated with driving errors than were adjusted scores for each neuropsychological measure, and among healthy elderly and Parkinson's patients. When predicting real-world activities that depend on absolute levels of cognitive abilities regardless of demographic considerations, predictive accuracy is diminished by demographic corrections.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Alzheimer Disease / physiopathology*
  • Automobile Driver Examination
  • Automobile Driving*
  • Female
  • Geriatric Assessment
  • Humans
  • Male
  • Mental Status Schedule
  • Models, Psychological
  • Neuropsychological Tests*
  • Parkinson Disease / physiopathology*
  • Predictive Value of Tests
  • Psychomotor Performance / physiology*
  • Statistics as Topic