Medical Driving Assessment Outcomes in Seniors Using The KSCAr+Drive: An In-Office Screening Tool to Assist Clinicians in Determining Driving Safety and Who to Refer for Medical Driving Assessments
Journal Title: Journal of Parkinson’s Disease and Alzheimer’s Disease - Year 2018, Vol 5, Issue 2
Abstract
Objectives: The purpose of this study was to examine how the KSCAr might be utilized to help identify seniors with MCI/Dementia as safe vs. unsafe to drive, or for whom referral to a medical driving assessment was required; and more specifically, if a subset of the KSCAr subtests could generate clinical evidence to support driving retirement or the need for further driving assessment. Methods: Thirty patients from two Ontario Geriatric programs (Kingston and London) who were referred for and completed a Medical driving assessment (DriveABLE) received a cognitive assessment that included the KSCAr. KSCAr scores were compared between those who passed/failed the road test. The KSCAr subtests that differentiated between those who passed/failed the road test using t-tests were then selected to comprise the “Drive Score”. Discriminant function analysis was used to determine optimum cutoff scores for three groups: “PASS”, “FAIL” and “GREY ZONE” (where a road test was deemed appropriate). Results: Of the total sample, 41.4% failed the road test, including all female participants. Eight KSCAr sub-tests differentiated the PASS/FAIL groups, resulting in the Drive Score sub-scale. Optimal cut-off scores for each of PASS, FAIL and GREY ZONE groups were determined with the following prediction accuracy rates: PASS (89% accuracy), FAIL (100% accuracy), GREY ZONE (64.3%). Conclusions: The Drive Score, emerging from the short (20 minute) KSCAr dementia screen offers clinicians a rapid and easy way to include empirically-based outcomes into their consideration of whether their patients with dementia are safe/unsafe to drive or need to be referred for a medical driving assessment, based on the outcome of similar patients who completed a medical driving assessment.
Authors and Affiliations
Lindy A. Kilik
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