ArticleBMC geriatrics2014
The trail making test as a screening instrument for driving performance in older drivers; a translational research.
Article in BMC geriatrics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
18 citing papers in PubMed, 51 citations in OpenAlex.
- Medical Marijuana Initiation and Simulated Driving Performance Among Mid-to-Late-Life Adults With Chronic Pain: Prospective Observational Feasibility Cohort Study With Matched Controls.JMIR formative research · 2026Observational
- Validation and Clinical Application of a Developed Pedal Coordination Assessment Device for Older Drivers.Healthcare (Basel, Switzerland) · 2025Article
- Immersive Virtual Reality-Based Methods for Assessing Executive Functioning: Systematic Review.JMIR serious games · 2024Review
- Motoric Cognitive Risk Syndrome and Traffic Incidents in Older Drivers in Japan.JAMA network open · 2023Article
- Abnormal brain functional and structural connectivity between the left supplementary motor area and inferior frontal gyrus in moyamoya disease.BMC neurology · 2022Article
- Usability of Norm Values on Results from a Simulator Device and Cognitive Tests in Traffic Medicine.Medical devices (Auckland, N.Z.) · 2022Article
- Normative Data of the Trail Making Test Among Urban Community-Dwelling Older Adults in Japan.Frontiers in aging neuroscience · 2022Article
- Investigating a classical neuropsychological test in a real world context.Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference · 2021Article
- Brain-predicted age difference score is related to specific cognitive functions: a multi-site replication analysis.Brain imaging and behavior · 2021Article
- Assessment of cognitive screening tests as predictors of driving cessation: A prospective cohort study of a median 4-year follow-up.PloS one · 2021Article
- Validation of Brief Screening Tools to Identify Impaired Driving Among Older Adults in Australia.JAMA network open · 2020Article
- Default-mode network dynamics are restricted during high speed discrimination in healthy aging: Associations with neurocognitive status and simulated driving behavior.Human brain mapping · 2018Article
- Differential Contributions of Selective Attention and Sensory Integration to Driving Performance in Healthy Aging and Alzheimer's Disease.Journal of the International Neuropsychological Society : JINS · 2018Article
- Cross-sectional study assessing the addition of contrast sensitivity to visual acuity when testing for fitness to drive.BMJ open · 2018Article
- Cognitive basis about risk level classifications for the self-assessment of older drivers.Journal of physical therapy science · 2017Article
- Age-Related Changes in the Ability to Switch between Temporal and Spatial Attention.Frontiers in aging neuroscience · 2017Article
- Functional Changes and Driving Performance in Older Drivers: Assessment and Interventions.Geriatrics (Basel, Switzerland) · 2016Review
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Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn many countries, primary care physicians determine whether or not older drivers are fit to drive. Little, however, is known regarding the effects of cognitive decline on driving performance and the means to detect it. 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.
methodsThis translational study was nested within a cohort study and an exploratory psychophysics study. The target population of interest was constituted of older drivers in the absence of important cognitive or physical disorders. 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. Forty-five drivers also agreed to undergo further testing at our lab. On-road driving performance was evaluated by instructors during a 45 minute validated open-road circuit. Drivers were classified as either being excellent, good, moderate, or poor depending on their score on a standardized evaluation of on-road driving performance.
resultsThe 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. TMT was related to contrast sensitivity, motion direction, orientation discrimination, working memory, verbal fluency, and literacy. 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 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%.
conclusionIn screening settings, the TMT would have clinicians uselessly consider driving cessation in nine drivers out of ten. 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.
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