Errors versus speed on the trail making test: Relevance to driving performance.

Area of Science:

• Neuroscience
• Gerontology
• Traffic Safety

Background:

• Trail Making Test (TMT) speed is linked to driving safety, but optimal cut-off scores remain debated.
• Older drivers are a focus for driving safety research due to age-related cognitive changes.

Purpose of the Study:

• To determine optimal cut-off scores for TMT A and TMT B speed to predict driving impairment in older adults.
• To evaluate the utility of TMT error scores in assessing driving fitness.

Main Methods:

• Retrospective analysis of 373 drivers aged 65+ referred for driving evaluations.
• Utilized TMT Parts A & B, Folstein Mini Mental Status Examination, and Washington University Road Test.
• Compared drivers with and without Cognitive Impairment (CI).

Main Results:

• For drivers with Cognitive Impairment (CI), TMT A speed > 46s predicted road test failure; TMT B speed was not sensitive.
• For drivers without Cognitive Impairment (NCI), TMT B speed > 131s predicted driving impairment; TMT A speed was not sensitive.
• TMT error scores did not predict driving fitness in either group.

Conclusions:

• TMT speed, particularly TMT A for CI and TMT B for NCI groups, is a valuable predictor of driving performance.
• Error rates on the TMT are not useful for determining driving fitness.
• Healthcare providers should consider pre-existing cognitive status when interpreting TMT results for driving safety assessments.