Ability of the Maze Navigation Test, Montreal Cognitive Assessment, and Trail Making Tests A & B to predict on-road driving performance in current drivers diagnosed with dementia.

AIM: This study aimed to evaluate the ability of the Maze Navigation Test (MNT), Montreal Cognitive Assessment (MoCA) and Trail Making Tests A & B (TMT A & B) to predict on-road driving performance in current drivers diagnosed with dementia. METHODS: Current drivers with a diagnosis of dementia in whom there were clinical concerns about their driving safety were invited to participate between December 2014 and February 2018. Participants completed the MNT, MoCA and TMT A & B, then underwent a blinded specialist Occupational Therapy & Rehabilitation Service (OTRS) off-road and on-road driving assessment. RESULTS: Of the 34 participants, 19 (55.9%) retained their full license and 15 (44.1%) received driving restrictions (including cessation). Only completion time for the MNT (AUC .737, p=.019), the MoCA domain of attention (AUC .809, p=.003) and a combination of the MoCA domain of attention and visuospatial/executive (AUC .783, p=.006) predicted outcome. Derived optimal cut-scores were <443s for MNT completion time (sensitivity 73.3%, specificity 68.4%), <5/6 for MoCA-attention (sensitivity 73.3%, specificity 72.2%) and <8/11 for MoCA-visuospatial/executive+attention (sensitivity 80%, specificity 66.7%). Using these derived cut-scores, MNT completion time predicted poor performance during the on-road assessment in the domains of speed control (p=.039), planning/judgement (p=.004) and vehicle position (p=.028). CONCLUSION: Results of this study indicate MNT completion time and the MoCA domains of attention and visuospatial/executive could be used to inform driving ability and further referral for a specialist driving assessment.