Prediction of Driving Ability with Neuropsychological Tests: Reference to Demographically-Adjusted Norms Diminishes Accuracy

In clinical neuropsychology, demographic adjustments to test scores are assumed to enhance the accuracy of inferences based on neuropsychological assessment. However, adjusting scores for demographic factors may diminish predictive accuracy for complex real-world activities, compared to unadjusted (“raw”) scores. It was hypothesized that driving ability can be predicted significantly with raw scores, and that demographically-adjusted scores diminish predictive accuracy. Participants were community-dwelling drivers, aged 65+, with MMSE of 26+. Twenty-four were normal controls (NC); 26, Alzheimer’s disease (AD); and 33, Parkinson’s disease (PD). Neuropsychological assessment included five measures correlated with driving performance: Trail Making Test, A and B; Complex Figure Test; Benton Visual Retention Test; and WAIS-III Block Design Test. Driving performance was assessed with a standardized 45-minute on-road driving test. Multiple linear regression revealed that a model with raw scores from all five neuropsychological measures was significantly predictive of driving errors (R2 = .196, p<.006). A parallel model with demographically-adjusted scores was not significantly predictive (R2 = .112, p>.11). The multiple correlation of raw scores with driving errors was significantly higher than for adjusted scores (p<.01). Follow-up analysis showed higher correlations for raw scores than adjusted scores for each of the five neuropsychological measures. Demographic corrections to test scores diminished predictive accuracy for one important real life competency, driving safety, an effect observed across neuropsychological measures and across neurological status: healthy vs. neurodegenerative disease. These findings reflect that competency in complex real life activities depends on ability levels, regardless of demographic considerations.

Language

  • English

Media Info

  • Media Type: DVD
  • Features: References; Tables;
  • Pagination: 12p
  • Monograph Title: TRB 89th Annual Meeting Compendium of Papers DVD

Subject/Index Terms

Filing Info

  • Accession Number: 01156994
  • Record Type: Publication
  • Report/Paper Numbers: 10-1740
  • Files: TRIS, TRB
  • Created Date: Jan 25 2010 10:47AM