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Prediction of driving ability with neuropsychological tests: Demographic adjustments diminish accuracy

Published online by Cambridge University Press:  05 May 2010

JOSEPH BARRASH ,
ASHLEY STILLMAN ,
STEVEN W. ANDERSON ,
ERGUN Y. UC ,
JEFFREY D. DAWSON  and
MATTHEW RIZZO
JOSEPH BARRASH*
Affiliation:
Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa
ASHLEY STILLMAN
Affiliation:
Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa
STEVEN W. ANDERSON
Affiliation:
Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa
ERGUN Y. UC
Affiliation:
Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa Neurology Service, Veterans Affairs Medical Center, Iowa City, Iowa
JEFFREY D. DAWSON
Affiliation:
Department of Biostatistics, University of Iowa, Iowa City, Iowa
MATTHEW RIZZO
Affiliation:
Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa
*
*Correspondence and reprint requests to: Joe Barrash, Ph.D., Department of Neurology, 2155 RCP, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242. E-mail: joseph-barrash@uiowa.edu
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Abstract

Demographically adjusted norms generally enhance accuracy of inferences based on neuropsychological assessment. However, we hypothesized that demographic corrections diminish predictive accuracy for real-world activities with absolute cognitive demands. Driving ability was assessed with a 45-minute drive along a standardized on-road route in participants aged 65+ (24 healthy elderly, 26 probable Alzheimer’s disease, 33 Parkinson’s disease). Neuropsychological measures included: Trail-Making A and B, Complex Figure, Benton Visual Retention, and Block Design tests. A multiple regression model with raw neuropsychological scores was significantly predictive of driving errors (R2 = .199, p = .005); a model with demographically adjusted scores was not (R2 = .113, p = .107). Raw scores were more highly correlated with driving errors than were adjusted scores for each neuropsychological measure, and among healthy elderly and Parkinson’s patients. When predicting real-world activities that depend on absolute levels of cognitive abilities regardless of demographic considerations, predictive accuracy is diminished by demographic corrections. (JINS, 2010, 16, 679–686.)

Keywords

AgedAge factorsAutomobile drivingGeriatric assessmentParkinson’s diseaseAlzheimer’s disease
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 16 , Issue 4 , July 2010 , pp. 679 - 686
Copyright
Copyright © The International Neuropsychological Society 2010

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