Prediction of driving ability with neuropsychological tests: demographic adjustments diminish accuracy.

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.

Barrash, J., Stillman, A., Anderson, S., Uc, E., Dawson, J., & Rizzo, M. Prediction of driving ability with neuropsychological tests: demographic adjustments diminish accuracy.. 16 4 679-86. 10.1017/S1355617710000470.