Moca test score bell curve drivers#

For example, a recent study showed limitations of the TMT in correctly identifying patients deemed unfit to drive. Like most neuropsychological tests, there is only a weak association between on-road evaluations and TMT performance values. Since then, studies have shown the TMT to be one of the best performing paper-and-pencil–based neuropsychological tests in predicting driving difficulties.

Moca test score bell curve drivers#

Its ability to assess fitness to drive was first tested in 1992 for patients with closed brain injury and for older drivers the following year. During the late’40s and early’50s, two of its creators, Armitage and Reitan, then transposed its application to assess brain injury in patients following stroke. The trail making test (TMT) is a neuropsychological paper-form test that was initially developed by the US army during the second world war to evaluate overall performance in new recruits. Given the important negative impact this could have on older drivers, this study confirms the TMT not to be specific enough for clinicians to justify driving cessation without complementary investigations on driving behaviors. In screening settings, the TMT would have clinicians uselessly consider driving cessation in nine drivers out of ten. TMT had a sensitivity of 63.6%, a specificity of 64.9%, a positive predictive value of 9.5%, and a negative predictive value of 96.9%. Older patients with a TMT-A ≥ 54 seconds or a TMT-B ≥ 150 seconds have a threefold (CI95% 1.3 to 7.0) increased risk of performing poorly during the on-road evaluation. TMT was related to contrast sensitivity, motion direction, orientation discrimination, working memory, verbal fluency, and literacy. The area under the receiver operator curve for detecting poorly performing drivers was 0.668 (CI95% 0.558 to 0.778) for the TMT-A, and 0.662 (CI95% 0.542 to 0.783) for the TMT-B. Drivers were classified as either being excellent, good, moderate, or poor depending on their score on a standardized evaluation of on-road driving performance. On-road driving performance was evaluated by instructors during a 45 minute validated open-road circuit. Forty-five drivers also agreed to undergo further testing at our lab. We therefore recruited and tested 404 home-dwelling drivers, aged 70 years or more and in possession of valid drivers’ licenses, who volunteered to participate in a driving refresher course. The target population of interest was constituted of older drivers in the absence of important cognitive or physical disorders. This translational study was nested within a cohort study and an exploratory psychophysics study. This study explores to what extent the trail making test (TMT) can provide indications to clinicians about their older patients’ on-road driving performance in the context of cognitive decline. Little, however, is known regarding the effects of cognitive decline on driving performance and the means to detect it. In many countries, primary care physicians determine whether or not older drivers are fit to drive.