In my car the brake is on the right: pedal errors among older drivers

PURPOSE: To assess to what extent specific cognitive functions contribute to pedal errors among older drivers. METHODS: 180 subjects aged 65 and older completed a 30 min driving evaluation on a simulator as well as three cognitive tests, the Mini-Mental State Exam (MMSE), the Clock Drawing Test, and Trailmaking Part A and B. Analyses based on logistic regressions were performed using age, gender, MMSE, Trailmaking Part A and B, and Clock Drawing Test as independent variables. RESULTS: Results indicate that Clock Drawing is the best predictor of pedal errors (odds ratio=10.04, p<.0001, 95% CI: 3.80, 26.63) followed by age > or =84 (odds ratio 6.10, p<.05, 95% CI: 1.77, 21.03). In contrast, Trailmaking Part A and B, gender, and the MMSE were not significantly related to pedal errors. CONCLUSION: Executive dysfunction may be an important contributor to pedal errors and thus unsafe driving. Practitioners may wish to consider measures of executive function when evaluating patients for driving safety.