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Cognitive screening and driver self-appraisal as predictors of naturalistic hazardous events in cognitively intact older drivers: a prospective cohort study in Japan

Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background Although cognitive screening and self-appraisal have been examined in relation to driving performance on road tests and simulators, whether they correspond to naturalistically recorded driving behavior in cognitively intact older adults remains unclear. We examined associations of the Mini-Mental State Examination (MMSE) score and three self-appraisal indicators with hazardous driving events in a naturalistic cohort. Methods In a prospective cohort, 192 cognitively intact drivers aged 60 to 75 years (mean MMSE 29.3, SD 1.0) in Hamamatsu, Japan, had telematics installed in their vehicles for three months. Rapid acceleration, hard braking, and sharp steering were recorded automatically at a fixed kinematic threshold. Negative binomial regression, with log driving time as an offset and adjustment for age, sex, and education, tested associations with MMSE score and with three self-appraisal indicators (self-rated driving ability and self-perceived cognitive decline while driving and in general). Equivalence analysis quantified the precision of null results. Results MMSE score was not associated with the rate of any event type (incidence rate ratios [IRRs] 0.845 to 1.089; all corrected p ≥ .224). Equivalence analysis constrained the effect to IRRs below about 1.2 to 1.4, excluding moderate-to-large associations. None of the three self-appraisal indicators was associated with any event rate (all corrected p = 1.00). Adjusting for advanced driver-assistance systems did not alter the estimates. Conclusions In cognitively intact older drivers, neither MMSE score nor brief self-appraisal predicted naturalistic hazardous event rates. Global cognitive screening does not appear to capture real-world driving risk in this population.
DOI: 10.21203/rs.3.rs-10826467/v1
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W7204870779
Cites: 37
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Related to: 10