Fitnessto drive: A neuropsychological perspective

Abstract

Abstract Within the healthcare setting there is a growing awareness of increasing numbers of people in the elderly and neurological populations who may no longer be fit to drive because of damage or progressive disease in the nervous system which impairs the cognitive systems subserving driving behaviour. The quest for a valid and reliable neuropsychological battery to test for fitness to drive has been dogged by inadequate understanding of the cerebral systems underlying driving behaviour and an over-reliance on a traditional psychometric approach. Tests are too often IQ-related and sometimes bear no relation to the cognitive systems specifically involved in driving behaviour. analytical approach which is more focused on detecting deficits within the individual neuropsychological components of driving behaviour, tests can be interchanged more easily as and when they evolve, and research units may better co-ordinate their efforts in producing the most sensitive, reliable and adaptable screening battery. Those neuropsychological skills that are recognised to be essential for driving behaviour are those of the visuo-perceptual system, the praxis system and the executive system. To the extent that they are presently understood, a breakdown of the subcomponents of these systems is described together with simple neuropsychological tests which best reflect them. By using an