Although driving impairments take a variety of forms (both functional and cognitive), dysfunctions which affect mental capacity account for the majority of cases leading to license revocation. Physicians in Oregon are required to report patients who they consider unfit to drive due to severe and uncontrollable medical conditions. Of the 1,700 who were reported in 2008, two-thirds were due to cognitive impairments. Of those, 60% were over the age of 70. Diagnosis and age alone do not determine driver fitness. A person with Alzheimer’s disease, for example, may or may not be fit to drive. Physicians and licensing agencies have struggled to establish objective standards by which to judge the point at which the impairment constitutes unsafe driving. In-office tools such as the Mini-mental State Examination (MMSE) are widely used to screen cognitive impairments. These tests do not, however, link the level of judgment and decision-making capacity with driver fitness.
Canadian licensing agencies use the DriveABLE™ assessment tool to determine the cognitive fitness of medically at-risk drivers. To date it is the only scientifically validated driving evaluation system for determining driver competency for individuals with persistent cognitive impairments. Developed through award winning university research, DriveABLE™'s science protects the safe competent driver from being misidentified.
The DriveABLE™ system involves a two-part review. First, clients are assessed using a computer-based test with a simple push-button and touch screen system involving exercises that depend on memory, judgment, decision making, attention, and motor speed. Second, clients are taken for an on-the-road test drive by a trained driving evaluator using a car with dual brakes. The driving evaluator rates the number and type of errors that the driver makes. Hazardous or potentially catastrophic competency defining errors are recorded. Encrypted raw scores are sent to the Home Server where data is scored. A report is automatically generated at the local testing center and the results given to the referring physician, or client.
If there is a decline in the ability to do everyday tasks, or if there is memory loss, poor judgment, indecisiveness, disorientation or loss of strength, flexibility or balance, it is time to determine if these changes are affecting driving.
