Cognitive Testing of Older Drivers

Senior DriverI am often asked about driver testing, particularly now that some older drivers are being given cognitive testing as part of the mandatory medical evaluation at and after age 80. This is called the SIMARD test and was developed at the University of Alberta in Edmonton. It allows the doctor or their medical staff to quickly and accurately identify people who are having cognitive difficulty that would compromise safe driving.

The first of four parts has the examiner slowly read a list of ten words to the subject. When all the words have been read, the person is asked to repeat as many of those words, in any order. Once completed, the task is done for a second time using the same word list.

Part two is a number conversion exercise. The subject is given a sheet of paper with a column of numbers and asked to write the numbers in words. An example of the task is seeing the number 5 and writing the word five.

The third challenge is to name as many items as possible that are sold in a supermarket within one minute. The maximum score is achieved by mentioning 30 distinct items.

Finally, we return to the word list in part one for the final test. The subject is asked to recall as many of the words read to them in part one as they are able to.

While this may seem trivial to you and me, it gives the medical examiner a proven yardstick to apply to their patients and fairly assess the driver. Many people are able to mask cognitive impairment during a routine medical visit and the SIMARD test helps the doctor be confident of their decision whether or not to recommend further testing and possible driving sanctions.

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Comments

There is some interesting commentary ...

... to be found on this forum.  But perhaps our site host is already a participating member?

This is a very complex subject, on a topic that's of interest to many.

 

Old Drivers

While I agree that over the age of 80 this should happen, I don't agree with the fact that they have to pay for it! Most people in their retirement don't have a lot of extra at the end of the day and now they have to shell out $80-$200 for a test, just to keep their drivers license?

C'mon! The system is broken! Let them have the test for free.! They still have to pay to have their license renewed anyways!!!

It's just Sad!!!

 

It ain't necessarily so.

To be clear, turning 80 doesn't force anybody to do anything more than have their physician complete a Motor Vehicle Medical Exam; if there are no concerns about their physical or psychological abilities, they will be able to renew their license just like that.

Furthermore, seniors (65+) are able to get their Class 5 Re-Exam for free, so provided this option is available to them then there's no cause for them to have to pay $80 - $200 for a test (though I believe the DriveABLE examination is closer to $300, should they choose to undergo that in response to concerns about cognitive ability).

And as for having to pay to have their license renewed, they get a great deal on that - $17 rather than $75 for a five-year renewal which is what the rest of us would have to pay.

Incidentally, if a senior opts to surrender their driving license, ICBC will cheerfully provide them with a BCID card instead.  And, there's no charge for this.

So maybe the system isn't as broken as you think?

Cognitive testing of Older Drivers

An interesting concept-

Testing short term memory for an ability in a long term memory skill-questionable at best, somewhat like asking your doctor for help with a mechanical problem with your car-ha!   

Second point--how the ability to talk fast is related to your ability to drive? Most of the con men I have met were very fast talkers--Makes them better drivers????

Third point--how removing lightly productive members of society and putting them in the position of being fully dependent --gains society in what way?? The members are belittled - the net cost to society goes up exponentially--the gain???????????? I feel that it is discrimination at its' very worst and few raise the eyebrows-let alone their voices.

Just a humble opinion

Independence vs safety is the real issue.

Third point--how removing lightly productive members of society and putting them in the position of being fully dependent --gains society in what way?? The members are belittled - the net cost to society goes up exponentially--the gain???????????? I feel that it is discrimination at its' very worst and few raise the eyebrows-let alone their voices.

I suspect that you're not understanding the issue, here.  Same goes for many. But there isn't any desire on the part of the licensing authorities (ICBC, in this jurisdiction, but this issue is almost universal in the developed world) to remove the driving privilege from old folks.  There is, however, a responsibility to ascertain whether drivers are entitled to their license - and this can change with the passage of time; if it were otherwise, then 5 year old children could apply for one.

As I would see it, the 'problem' is this: at some point in time, one of two things is going to happen to every driver:

  • They will die.
  • They will become incapable of operating a motor vehicle safely.

This applies to you, me, our site host, everybody reading this, it is universal.

Accepting that the death thing pretty much makes this discussion redundant, then it's going to be either a physical or pyschological ailment that renders a driver incapable or incompetent.

At one time in human history, and probably not that long ago, physical ailments would have been sufficiently predominant amongst older folks in general as to render this problem moot.  But these days, in our society at least, people live longer.  And longer.  There is much greater potential, due to the mental issues with cognitive awareness, for a person to be able to get behind the wheel of their automobile and drive it, even though their brain is no longer able to govern and process this mental task load.

I'm not saying that the cognitive testing that's being used (as an alternative to a regularly structured Class 5 Road Test by an ICBC Driver Examiner) is perfect; but then, neither is the fundamental Class 7 N test that's required for a first time driver.

But the criteria, the rationale, for these tests are entirely different.  And if a senior has reached the point (unbeknownst to them) where they're no longer capable of processing the task of driving, then much better they be removed from being behind the wheel than make some cognitive error that results in death or injury; to themselves, to you, to me, or maybe to our children.

That's what this is about; that's what the net gain to society may be.

The Simard Test

I would like to add my two bits worth on this topic, as I am approaching 80.

Regarding the test:

Language:  Does the test have to be in English? Can it be in any language of choice? If not, why not? Are we required to be fluent in English in order to drive a car in our old age?  (Does the charter of rights apply here?)

I have a number of elderly friends who have never mastered English, and they are likely to stumble on the test for this reason.

Memory test on 10 words: I have always had a problem remembering words, particularly names. Sometimes to embarrasment. However, I have a propensity for remembering numbers with considerable ease, such as telephone numbers. Accordingly, I could potentially fail this part of the test. This condition has not prevented me from working successfully for 50 yrs, or driving my car without accidents. So, why not allow a choice of say words or numbers?  What is so definitive about words? What is wrong with using 10 numbers?

Listing 30 items purchasable from a super market, and under 1 minute:  let's take the case of my brother, approaching 80. He has never shopped for groceries in his life, let alone done any cooking at home. This doesn't suggest that he doesn't know what a tomato is, or a potato, but my guess is that, confronted with a 1 minute time factor, he would probably get as far as bread, eggs and bacon, and butter..sugar, tea and milk (which kind of summarizes his meals). So, what is so unique about this part of the test, or perhaps is this simply a very unfair test. My brother has worked all his life and driven without accidents.

I think the Simard test is palpably wrong. It emmanated from a university husband and wife team, as a nice side line business, and the university backdrop is taken by the provinces as being gospel, or perhaps it removes the onus from their shoulders when it comes to dealing with elderly drivers.  But don't get me wrong. Yes, as we get older, driving a car has significant liabilities for us seniors. And we need to stop driving when the time is right. For me, the Simard test is not a good way to weed out seniors, as exampled above. I am keeping my fingers crossed that my doctor will find me fit and capable to continue driving when I hit 80 and thus not have to take the Simard test.

I rest my case, and look forward to any replies or comments

 

 

 

SIMARD-MD is Faulty

I have just read your comments on the virtues of the Simard MD dementia test, and was surprised that you condone it. It is known by all of the experts to be faulty and those that contrived it, admit to only being at best 50% accurate. There is no known dementia test that is excepted as accurate enough to make definitive judgements, and the Simard is responsible for removing many licences of elder drivers unfairly.

ICBC Road Testing changes.

This post has nothing to do with the Simard test -  or any other cognitive testing (such as DriveABLE computer testing), but I think it's probably relevant when it comes to the alternatives available to seniors.

Incidentally, during my career I have conducted several thousand Road Tests; many as a supplementary Driver Examiner for ICBC, some as a Training Assessment Officer for private industry (Driving Instructor trainees and Class 4 trainees), some as a DriveABLE Examiner, others as a contract evaluator under the auspices of the then OSMV aka Road Safe BC.

Thanks to an initiative launched by (now retired) Blair Grant, ICBC Regional Manager (Licensing), a new Class 5 Senior's Road Test examination form is in use. And the format is the same old demerit points system as most of us who took a test in BC encountered, except that the number of demerits assigned for any error is only 5, there are no 10-pointers.

Easy to understand (far better than the Class 5/7 being used for new drivers, and those from none-reciprocal jurisdictions) but effective none the less in removing those who are no longer competent; whilst providing clear information on the areas where they need to improve, should they be inclined.

Just so you know.

 

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