‘No evidence’ for use of cognitive test Crash in Meridian complex
GREY Power is calling for a change to elderly driver assessments, claiming the process for assessing driver capability is penalising some of the very people who need their licences the most.
Grey Power acting vicepresident David Marshall said a nationwide survey of members had revealed a lack of practical driving assessors in the regions, and also widespread use of cognitive tests — SimardMD and MiniACE — to assess driver impairment.
Canadian driving researcher Dr Alexander Crizzle said there was no evidence to support the continued use of cognitive dementia tests to assess driver capability.
In New Zealand, the driver licence renewal criteria require all licenceholders to present a medical certificate confirming fitness to drive at age 75, then 80, and then every two years following.
NZ Transport Agency Waka Kotahi said it did not mandate cognitive tests for elderly drivers and maintained the use of such tools was left to the discretion of health practitioners.
Draft guidelines on how to assess medical fitness to drive were currently under review and were expected to be released in June.
Dr Crizzle said the SimardMD test was used to identify drivers who were at risk, but there was an argument that the test ‘‘does not do a great job’’.
‘‘The reason why there’s so much controversy is because if you somehow fail that test, many don’t undergo a road test, they just lose their licence and that’s been a huge issue for many.’’ There was mounting evidence about whether the test was effective and in some areas it was being pulled, he said.
The MiniACE test which is used in New Zealand asks questions such as what day, date and month of the year it is, to remember a name and address, and to name as many animals as possible in a minute.
Dr Crizzle said the MiniACE test was quicker to administer than the SimardMD test, but there was still not a lot of data to support its efficacy.
The tests were designed to identify people with cognitive impairment and were not designed for driving and there was no specific test to understand driving deficits, he said.
Every person was different and there had been studies that showed some people with earlystage dementia were still driving and could do so safely, he said. Better tests were needed to identify the specific deficits and to understand what issues were occurring when people had cognitive impairment, he said.
From a practical perspective, a
SimardMD test could lead to 20% of people failing the test, half of the candidates having indeterminate results, with 25%30% passing the test, he said.
‘‘That means you’re testing 70% of your clients on the road.
‘‘And if you put that on a population level, that’s a lot of road tests that you’re conducting that you shouldn’t have to conduct.’’
It forced people to have the stress of taking a road test when they could clearly pass it, he said. He said ultimately a road test was really the only way to know whether someone could drive safely or not.
Grey Power acting vicepresident David Marshall said older people who had to seek a certificate from their doctor were getting stressed after hearing about what others had experienced.
Some GPs were still using the SimardMD test, while others used the mocker test or the MiniACE, he said.
GPs were either referring those who failed for an onroad safety test which cost about $20, but if the GP referred them to an occupational therapist the cost was about $800 or up to $1200 if the occupational therapist came to see them, he said.
The issue with the road test, particularly in rural areas, was that very few places offered that particular test, he said.
For many who had to sit this test the expense and fear that they might not pass meant they just gave up their licences. — RNZ