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Title: Effect of Navigation Problems, Assessment Location, and a Practice Test on Driving Assessment Performance for People with Alzheimer's Disease.
Austin Authors: Unsworth, Carolyn A;Russell, Kay ;Lovell, Robin;Woodward, Michael M ;Browne, Matthew
Affiliation: Swinburne University of Technology, Melbourne, Australia
School of Health, Medical and Applied Sciences, Central Queensland University, Melbourne, VIC, Australia
Austin Health, Heidelberg, Victoria, Australia
Issue Date: 2019
Publication information: Journal of Alzheimer's disease : JAD 2019; 67(3): 1035-1043
Abstract: People with Alzheimer's disease may be required to undertake clinical and on-road assessments to determine fitness to drive. The manner in which on-road assessments are conducted with drivers who do and do not have navigational problems may affect the outcome. Investigate the effect of 1) navigational difficulties, 2) location of assessment (un/familiar area) and assessment order, and 3) undertaking a second assessment (practice), on passing an on-road driving assessment. Forty-three drivers undertook an Occupational Therapy-Driver Assessment Off Road Assessment (OT-DORA) Battery which included the Drive Home Maze Test (DHMT). Participants with/without a history of navigational problems were randomly allocated into three groups: 1) Unfamiliar/then familiar area assessment; 2) Unfamiliar/unfamiliar; 3) familiar/unfamiliar. An on-road assessment protocol was used including over 100 expected behaviors at nominated points along the directed route. For familiar area assessments, the driver self-navigated from their home to shops and services. A pass/fail decision was made for each assessment. A generalized linear mixed effects model showed neither location, nor practice affected passing the on-road assessment. Participants with navigational problems were six times less likely to pass regardless of route familiarity and direction method, and the DHMT was a significant negative predictor of passing. Drivers with Alzheimer's disease who have navigational problems and are slow to complete the DHMT are unlikely to pass an on-road assessment. However, navigation and maze completion skills may be a proxy for an underlying cognitive skill underpinning driving performance.
DOI: 10.3233/JAD-181069
PubMed URL: 30776013
Type: Journal Article
Subjects: Alzheimer’s disease
automobile driver examination
automobile driving
occupational therapy
Appears in Collections:Journal articles

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